HomeMy WebLinkAboutPermit Building 1974-10-8
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PERMIT11 ~ -&--7tj
lANE COONl'Y Building
DEPAR'IMENl' OF ENVIRON1ENTAL MANAGll1ENl' Mobile Hane
APPLICATION FOR OOllDIN; PERMIT OR MOBIlE HeME USE
NCJI'E: No pennit will be issued tnltil this application has been approved.
~~TION /1 is- La(/-"el) y,~'~".K-el(. (J "'?J.--
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'M' 1'"6 RAN:;E ~ SEC. (g, I. ':l., TAX LOT 111 OS()() COOE /q-[CiJ CENSUS TRPCT35'"-152.C-1
LOT NO. BLOCK SUBDIVISION
PROPERlY SIZE
ACCESS TO PRut'J:.K1IL~<>~el >t WID'lli DEP'llI. OR ACREtCE
DESCRIBE EXISTIN:; STRlJCIURES ON TIlE PRurJ:.tUI r ~ A"~. /" XI d ~~..P ~ .
APPLICANl' , / II. / MAlLIN; . ' ,1/ ,/ 7- itsl
NAME (f)tt"t:(/" . rlp",-K.'><s ADDRESS lor Lex.VH"/ )'{;>vz.. PHCNE .,cJ-7- ~6
OJNrRACIOR I; MAlLIN; , . .
NAME lSoh Sd./dV' Auut=>s2Q7$" C~((~7te~{;.,Y~ONEr4-2.-8'1/-7d
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BELCW FOR OFFICE USE ONL'I......:.:. :.:...:...:.:. :...:. :....... ............ :.:.:.:...:. :.:...:...:. :.:. :.:.:.:.:.nn..nn :n.:. :.:... :.:.:.:. :..;:.:. :.:. :..;.;:.:.:<f<
::ltructures to be built/Mobile Hare sq. ft. 1tbedrocm; valuation
- I -../ .../
'Iype ot st:ructure~1J/_9ccupanc;-.J Fire Zone
Blgd. setbacks-tt. trem center ot road right ot way
Front.r-./:> Side Int. /~ Side Exterior
date sanW\on
/~ - ,:),-7 Y J\\.\..-
.
p~ P,I~~A
M J-n i C90r1
:iewage V:ispesal:
Site Inspection 11
Water ::;\:IEply:
PublicU District Nama
Bldg.
Waste Dis.
Plumbing
Plan Review
Trailer
1% surcharge
2St.
.:ur
TOrAL
.:\'iL 2. 'ill
Min. Septic tank capacity
with mst. box: Gallons
Planning
j;7u./
C55-12
~){" f..'Lc.J
to ZJ..I ~ .~. ~n
3~()J.LO
Existing sewage disposal system 0 or new system requ:iJ:;ed 0
Well 0 Spring 0 Other /
Fees
Plumbing Installed by <Mner Other Nama .
Plumbing Fees Sewer connection
11 of fixtures inspection fee
ater connection
inspection fee
o ~ Plans furnished Facility Pennit
~eck Yes a-No 0 sO
Signature of Applican~ ~. _~te~,Af
Fee re~eived by t'.(.AlIY l!'v\ date- {O-2-1<j
Drainfield rEiHuired
. .
Lineal Feet
Depth
or Sq. Ft. .
'"*
Use Classification
Rear
s-
Zone d ~?--
iiblzv Mt'fi~!L M-'l':;n
.
~ PERMITit .2.1 lPr,-lL/
lANE CXXJNlY Building f
DEPARIMENr OF ENVIRON1ENTAL fubile Hare
APPLICATION FOR BUllDm; PERMIT OR l-DBIlE HCME USE
NOTE: No pennit will be issued until this application has been approved.
PLEASEPRINl' .J
PROPERTY LOCATION 1/ J}' L (1(/ ,.,~I S;: / S!>". /~e#' ()1,.0.
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1WP /g RAl'a 2. SEC. u./. J TAX LOr it/tI.>ef71 CJ:i)EN-In:? CENSUS TRlCfY~'-1>20
LOr NO. BLOCK SUBDIVISION
/ PRO~SI~
ACCESS 1D PRurCKJ.I L,v""'/ )t. WIDTH ~<10 DEPlH V6'1 OR ACRElGE
DESCRIBE EXISrm:; STRUCl'URES ON 1llE PRurCKJ.I ,(t7v,>-=- y Grr.." ')' e
APPLICANT r /11 I. MAILm; , . .j r" .//1
NAME t> ~,44Y _ 7ex~"'>1.f IillDID3S /11> Ldr-lA~1 5r..J1llffHrnE 74-7-'f77'
wLuN\CI'OR J / MAILIN:; j ",,'r 5'lf10
~~ Zeit) ;>e..:/~ IillDID3S7<ff /}" /fcl<<-"~ v";'~1nJHONE NJ'
BELCW FOR OFFICE USE ONLY>\""" "" "....""""" ......" ..".."".. ..".... ;...,,;..~..~..~..~. .~..; ,~..~.;.;..;;...../. ..;..~.;..~.;. .~..;.~..~. .~.;.;. .~. ,;;. .;.,;,;, :.:.;,
~q~tures to be builVMobile Hare sq. tt. itbedroans valuation
...,BdahhJm) 40 ~.J.Lri~..J1.JJ.LI.hm1j-. ."),7c.J (0) lto.lf) j Io02/.4tl
.l... BuL-c"')CY\'\S /'
1 bcd-It\. YOO"l'I'I /
I
:iewage Pisposal:
Site Inspection it
Water S~ply:
Public I..J District Narre
Bldg.
Waste Dis.
Plumbing
Plan Review
Trailer
1% surcharge
i.iO.
I -:{ ,
TOl'AL
~"53, S?>
Min. Septic tank capacity
with dist. box: Gallons
pvv 1-- h" pn "'+-
.s."'>
Existing sewage disposal systan m"or nelsystan required 0
\ P /,
I 'f
I Well 0 Sp~ 0 Other
Plumbing Instled by ().,mJ Other Name :
Foo, Pb"","" F~ ' ,...: ~_ "',& ~tioo
,::s it of . tures flspection fee 2 ,/)~pection fee 2.00
~ I ~~~ ~Ejh~ed ~1i'I., W ..U
Signa!:):Ire of !\Pplicant 7f1 . date ~7f
Fee reFeived/by_~.(J )~c te -'V
Drainfield r~rect
Lineal Feet V Trench Depth or Sq. Ft.
("")~ n-p" \ o,",",d, O\J -V- S../lc
Type of structure~occupancy I Fire Zone
Use Classification
Blgd. setbacks-tt. from center ot road right ot way
Front ~ f Side Tnt. I a :':"L:. d........;.ee
Planning
I ~=j.J""--- to I:u h cL
~- , I' (
C55-12
~
date ~t~tion )ti~5t/7'1 ~~L4t/tJ"~~7o/'
jJ~. ., f. u7 .
Rear
Zone ..A/.", I
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