HomeMy WebLinkAboutPermit Building 1977-9-7
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INFORMATION SHEET 7/,./ 7
) Site Feasibility Study for Septic Tank. Number of sites - ?
) WOuld~ike t meet on site. Call _ (owner, etc.)
Test hole illYfe rea --t? /'
) Completed Subdivision 'J A--.. --' Lot ~ Bloc~ I
( ) Pending J / 0#//77
APPLICANT'S NAME AND ADDRESS Eu q e.,ne.-. /'T-a /LJ,::r /~ c:7..l 79' .-r:fl~_/d:lt. ~o(np ?{/(t -6 ,3,f'".3
OWNER'S NAME AND ADDRESS, if different from appli';;ant's ." /J.!--h ""_ ~ / v Phonp
CONTRACTOR'S NAME AND ADDRESS -<'"~~ -E- Phonp
N[ail permit or results of site feasib!,!j.W study to ( ) Applicant ( ) Owner ( ) Contractor.
~r to pick up. Call ?V""~ -3 g-- ~ (owner, etc.) when ready_
.RUCTURES NOW ON THE PROPERTY 0~~
PROPOSED USE (this permit) ~\L,\ "'l:AOOV\.
WATER SUPPLY~~'f.:50~ l~",r-'l:::. ~~,...
SEWAGE DISPOSAl ~ -~\c:..
PLUMBING BY \.. J fA..
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) PROPERTY IS WITHIN ONE MILE OF CITY (
~ Building Permit
(
(
Acreage or Lot Sizp
Partitioning #
/,existing or proposed well, etc. If public, name of system)
/oxisting or proposed septic tank, etC-) S.1. ""
Address
...... *.. ** ** * * ** *.. ** ** * **.. * * ** *.. * * * * ** **.. * * * * * 0 FF I CE USE ON L Y BELOW TH IS LI N E * *... * * * * ** *.. *.... * *.. **.. * *...... * * ** * * ** **
* *.. * ** * *
( ~w dress Necessary ( ) Facility Permit Necessary
20 SETBACKS: Front _ Side Facing Street
'. (FROM CENTERLINE OF ROAOI
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
) Special Permit Area. Minimum Eleva~
Interior Side Yard Rear <:s:: II
(FROM PROPERTY LINES)
By
Permit Processing Section
Response'
C55-12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Perm it Processi ng Sect ion
125 East 8th Avenue
687-4394
"1ivision
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