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