HomeMy WebLinkAboutPermit Building 1982-11-24
'l .r.; -\\\').,~Ib)-~ _LANNING & COMMUNITY DEVELOPMENA .
'~r "'\)+~~cmITY INFORMATION-'SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
CD (! ~~SON W\KtJ?uC~
6ne county
.
qoUie/aW7~on
() 0 I PROPERTY O\'.'llER
~
MAILING ADDRESS
vI ~fL;W\~",~~
~ I CQ.; 971-17
v IfrTY I
ZIP CODE
CITY
STATE
74/- /1) 10
BUSINESS TELEPHONE nmlBER
12~1%O
HOME TELEPHONE NUMBER
BUSINESS TELJ;PHONE NUl>lBER
STATE
ZIP CODE
HmtE TELEPHOlJE NUMBER
.3
Tax Lot(s):
em .~"';;.jBER (from tax maps in DcpartmcnL ~ "'~_ssment & Taxation or
>>-</'1'
from tax.statcment):
'~
Map & Parcel N
Section'
Township
Range
nOut of TL
Tax Map & Parcel Number of Adjoining Property in Same Ownership:
Tax Lot(s):
~
o Unknown
Section
Township Runge
o None
C7
@) REQUEST (briefly describe information needed):
~~ L1A-f
\'i~n #m;ir
COMPLETE THIS SECTION FOR LAND USE,
CONSTRUCTION APPLICATIONS, OR PROPOSALS. SEE "NOTE BELOW.
Q)TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP, 'l'~
@PROPERTY ADDRESS, Z3:1s !./J~--,
~ r c/JAJf' j () --if ) iSv. IJJ!/
@ PRESENT USE OF PROPERTY, :r:;:; mt'':J Ph . tl IIf,CJfPc"3p,/ ~U
. [) -
acres
".
~ NUMBER OF STRUCTURES ON PROPERTY: Standard home_____ Mobile home
Modular home'
RV in use as residence_____
Storage
Garage_____ Shop_____
Other (specify) otf;;p__-1
Barn
'-
') (.',")
~ ACCESS TO PROPERTY: Public Road Name ~~~
Pbivate Road Name
Road Easement
# of
Users
Width
.-"-
@ OTHER EASEHENTS OVER PROPERTY,
Oaln mUJ
\
@ PENDING PERHITS ON PROPERTY'
@FIRE DISTRICT, ~~~
(i) WATER DISTRICT,
<fin"...,.
c
9/81 REV
(OVER)
By Partition #
BLOCK:
LOT,
~A~hLl7
**FOR STAFF USE ONLY**
/cf:)
~~
TIHE INITIATED, 3. 'tJ7 ~
ff
NUMBER:
DATE:
CHECKED BY:
ATTACHED EXHIBITS:
o Plot Plans (2)
[] Constr. Plans (2)
o Si te plan
o Copy of Tax Hap
DOther
SCREENING VERIFICATION:
By'
Date:
Time In: Out:
o Accept 0 Reject
Routed to:
*NOTE: ATTACH A COPY OF
TAX ;.1AP; SHOH EXISTING
STRUCTURES AND TAX LOTS
IN YOUR moJNERSHIP. OB-
TAm TAX MAP IN SELF
HELP AREA OF A & T.
COMPLETE THIS SECTION FOR LAND.E OR CONSTRUCTION APPLICATIONS~ **FOR STAFF USE ~**
Q9 PROPOSED USE OF PROPERTY IN DETAIL, ZONE/LAND USE,
~ BUILDING REQUESTS,
Contractor's #
(for mObile home setup also)
Directions to Site:
Check the type of permit requested:
o Dwelling: 0 New
o Addi ticD
o Addi tional;
o Replacement
o Alteration;
o Modular Home 0 Mobile Home - Model Year
o RV 0 Standard Construction;
o Plan Check Only
o Commercial: Use
Floor Area
..
o Agricultural: Use
D Others: Use
Floor Area
o Change of Use - How?
~ NUMBER OF BEDROOMS
NUMBER OF STORIES
{) SANITATION REQUESTS:
[] Site evaluation for 5DS feasibility
o New system installation
[] Repair/replacement
o Alteration/relocation
o Hook to exis ting
~
ADDITIONAL INFORMATION,
By,
DiJ.te:
Time In: aut:
o Accept 0 Reject
o Planning Ap!>lication
[]Construction Permit App.
o Information Only
Zoning:
Compo Plan oesignation:__
SANITATION,
By,
Date:
Time In:
Out:
o Accept
o Reject
o Constr. Permit Issue
D Si te Evaluation Issue
PER}lIT ISSUED (5A}lE DAY ONLY):
Permit #
By:
Date:
Time In:
Out:
}~ON REWIRED FOR A tGN PERMIT
.
.. Permit Ntmber
Total Sq. Ft.
(erect )
Building permit application is to (ah.=. )
(rek....;;.~ . . ,)
~ sigiisaccording io ~tfications
and ~cription giyen. belOill and de- .
tiilea plans s~tted:..' :
. -
IDcation of Sign (Address) ~ I-ICll]ft;V1 fJrirlgp. }^inl~:Ol? 97!!lf
Name of Business . and Address --.limtPr \ tr' . (-.. ,'::acne: aMYp~ss : .
o..mer of Sign (Name and Address) fro t1 ,-S'lp,ar.t!lrQ;S ,. ':
Sign Erector (Name and Address)"" 'I '.
.. -: -'" :.\;#
. . ' , .
,
.' ,
r!
,.,
DIMENSIONS, VUl~LrtLlcrION & INSTAllATION Il'-IF'(RofATlON . .
Vert. Height of Signs Z'9" Horiz. Width of Signs 5'0"
Total Height Above Grade -4' b'
Material Sign is Constructed of k?E".fl woai
Type of Sign (Check Applicable Items)
Z Identity SignS v' Single Face./ Wall Sign
ThickneSs; & Depth. 5"
"
Of..
"
~ ...
. ~!;
Non-Identity Sign
Billboard
Double Face
Pole Sign
~e Sign
ProjeCting Sign
Other.
"
"
Multi-Face if
Roof Sign
'. ~ "
"V"Yl'Tl::'C" ,:' ~!
L'OVUA:>: ..
Plans Required: -"1\olo canplete sets of plans drawn to scale,./g~ ~ions .and .
/height or sign; /adv,ertising message on sign;V!ocation.of sign on l"~~p""~f.,\with climeihsi~.
to property lines ;lstructural details of supports, friuning, bracing arld. fQOtings ;vfnat:er-.,
ials of construction for sign and sign structure; electr-ical-equi~.L.;';~":::'.:.gh~it\g;.;
size and laeatien Qf P'iri~...4Y'lg 01gtW-~ ...._opc:L-ty-f......... ~,L.....,:..d::;.odt. " . i
Electrical-
trical division.
Permits for all electrical w:>rk shall be secrued frail'the sta!=e elec-
" .
M55-78