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HomeMy WebLinkAboutPermit Building 1973-05-30IANE COUNTY BUITDING PERMIT OR MOBILE HOME UsE APPLICATION PERMTT TYPE - BUTLDTNG E MOBTLE HOME EOSC REG.#PERMTT #,/z/-z OWNER NG ADDRESSe ADDRESS PHONE PHONE OFF ICE PROPERTY DESCRIPTION toT -K _ SUBDIV TWP RANGE METES & BOUNDS ATTACHED YES NO SEC TAX tOT CODE CENSUS TRACT-3aa DESCRI BE ING STRUCTURES ON PROPERTY IT ANYAPPTICANT NAJTAE AND ,\^AltlNG ADORESS FOR MOBILE HOME PERMIT ONLY Number of Bedrooms BE tT THIS PERMIT SEV/AGE D PUBTIC SEPTIC TANK TEGAL ACCESS TO PROPERTY _NAME OR PROPERTY SIZE-WIDTH DEPTH Connect to Existin o stem or ECO SQ. FT PTUMBING INST BY OWNER ER NAMEOTHER a)A FEES WATER SUPPTY PUBTIC PTUMBING FEES FACII.ITY PERMIT AREA VATUATION No! DATE 3 DATE m 5/ BtDG. V/ASTE DIS. PTUAABING PTAN REVIEW J -4- OTHER. PTANS F YES YES 2.9r't CASH E 7 a CHECK .oo FIXTUR.EStry* TOTAT MIN. SEPTIC TANX CAPACITY WITH DIST. BOX: GAL. PUBTIC WATER CONNECTION FEE COUNTY BUILDING & SANITATION IFICAIIONS DRAIN FIETD REQUIRED tIN. FT wt rT OR SQUARE FEET TYPE OF STRUCTURE OCCUPANCY ZONE REAR YARD PUBI-IC UTlt. EASETTAENT 5-U tr-2 L-Z Form # css-t2 USE CTASSIFICATION Dole BLDG. SETBACKS _ FT, FROM CTR. OF ROAD RIGHT OF WAY FRONT S}DE TNI. SIDE EXT. REAR IT Dole Doie BLDG. INSP irections lo Find Property: COPY I _ OFFICE COPY 2 _ JOURNAT COPY 3 - AUDIT FEE