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HomeMy WebLinkAboutPermit Building 1974-9-20 r ~~7AJVV\ lANE caJNlY Building DEPAR1MENT OF ENVIRON1ENI'AL Mobile Home APPLICATION FOR BUILDIN:; PERMIT OR MOBI' HCME USE PLEASE PRINI' NOTE: No pennit ~ll be issued tn1til~. is application tas been approved, PROPERlY LOCATION \-....Cl.rI\r ~~.51- '---L)es ~ ~,~-e.._ ~P('. A 1Y\"v-. c\ '--:::::\:-- of" "" <-,. ~~ - c... "'" c:- '.c< e '\\ <=. ~ J ' --" 'M' \'\ RAN;E c)~ SEe, \.~ TAX LOT IIQC'l(LCXIlE\..\-o4CENSUS TR!CI' LOT NO. j3I.JJCK _ SUBDIVISION ACCESS TO PRul't.K1~Pr\.~\';-o'\, ~ <:::\,.,--:\,€,,&~PER1Y ~IZE DEPlli - OR ACRE!GE ---.;, DESCRIBE EXISTIN; STRIJCIURES ON 1HE PRur=.J.-{ APPLICANr.L\ { ('.".1'\. I, MAll.IN3"" \ \, c:::. ""\ I ':)::::.O'-l~<2 II e.... NAME "-\''--~ "\. '\ '\ \a., '>.<.. ~a "'" Auu=S ~ ....., \.D "C) 0 )< r-J 10. ~t1CNE w~~, a~,~. CA~"cs.a=~~::?~Q..~~~" S-\: PHONE~k\I\--~~ l3ELClV FOR OFFICE USE ONLY*****:....,..:.......:. :.:.:.:...:. ,.:.:.:. ;.~;.-:'..;.;. ;.~,...;.;.;,;.....;..,;. ;...;.;, :... ;...:.;.;..~;. ;.;._. .\i,AAA AA ~uctures to be 1;>tri.;LtjMobi]& Home sq. ft~ 1Fblfdrooms I. valuation CO ()AA.Cll') 0 \,e~c.. \:\-o,\,~, l '~Y\..~'ocv \~t:::r\"-Y- ,---\r-., ~,......c..,\.€.. ~~. \..,~ ~. \e\l._~ V". c0- -, v.~~_r;~Q C\~-\n ~ \j--t-l. 'r 'Vrv~ ~ "'~'c u....~ . ~"'--""O""C.""'l -c;: ___"-- U~UC:: ::iewage J)1.spcillal: '- v Site Inspection II Zxisting sewage disposal systan 0 or new systan required 0 Water ::i'::!EPly: I( Public U District Nane Well ~ Spring 0 Other ~ -e'--\ ./ ....., Bldg. Waste Dis. Plumbing Plan Review Trailer 1% surcharge 1oL{.00 %-D~ ~ (~ ..., L 0ilieck Fees Plumbing Installed by O;vner Other Natre : Plumbing Fees Sewer cormection Water ~ection I-.\, II of fixtures inspection fee :iru;pedion fee -' /.- E'ifcility Pennit 0- [] , "s ~ datet.4;hb Plans furnishe Yes 0 No Signature of Appt.,.cant Fee received by ....... Drainfield required Lineal Feet ~ ,~,oo TOrAL ~ Min. Septic tank capacity with dist. box: Gallons Trench Depth or Sq, Ft. .J' ' Type ot Structure ~- {,} Occupancy! .hre Zone Blgd, setbacks-tt. trom center ot road right of way Front Side Int, Side Exterior Use Classitication Planning date ~ton q/;q/1Jr ~.. . Rear Zone J1j- Building /J' date F II .)., ..~ . 1 r: . . '" . ' I'J41Af 1.-.,.1 /:, "'/. ;}J) '.i , ' fi /~ C55-12