HomeMy WebLinkAboutPermit Building 1978-6-1
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Written Directions
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Job Location
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INFORMATION SHE'ET
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(~uilding Permit
( Y(Site Feasibility Study for Septic Tank. Number of sites
Acreage or Lot Sizp 'ClS'.70.j- /9 oS, ill. Test holes will be ready t:.-/ - ? fr
Partition~'!l " '" () () Completed Subdivision Lot Block
( ) Pending ~ :d
APPLICANT'S NAME AND ADDRESS ----CAiA14.ouj;''/ -h..-r CJ.kA~~ ""~ c';,r ~fIP ;z. Phone7.2h-?g/~
OWNER'S NAME AND ADDRESS, if different from i'Pplicaptjs <"~ - ' Phonp
CONTRACTOR'S NAME AND ADDRESS V,:A/Jp i"'nsr- ..i.~ilf'lU, ORJr.. Phono
.il permit or results of site feasibility study to ( ~pplicant 1.( ) Owner ( ) Contractor. ' r
) Prefer to pick up. Call ". (owner, etc.) when,r~. ~ Cx~~.l.. . ,,~~ctors O. S. ~
STRUCTURES NOW ON THE PROPERTY C IbM.Jt #- If-~ _ _- - "':'----b _ ^ I \
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~ c...~. \(l) t::lDY(";f'~xisting or propos~~c. public, name of syste:, -
~), t\. \:i<"~~~(In~tic tank, etc.) S.I.;;
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PROPOSED USE (this permit)
WATER SUPPLY RA:lJBt'1I.AJ
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SEWAGE DISPOSAl
PLUMBING BY
Address'
) PROPERTY IS WITHIN ONE MILE OF CITY (
..* __.* ~*********** ************************ OFFICE USE ONLY BE LOW THIS LINE ******".-It"" *.* **.... .*** ** ***.. **...,. **.. 'l".. +**.......
tit) New Address Necessary ( ) Facility Permit Necessary
NE ,.-f57~/ SETBACKS: Front #:2- Side Facing Street
IFROM CENTERLINE OF ROAOJ
( ) Special Permit Area. Minimum Elevation'
.e"..., Inte;ior Side Yard -;4- Rear
~ (FROM P-ROPERTY L1NE51
To: Planning/Building InspectorlSanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By_
Permit Processing Section
Responso'
B"
nivision
C55.12
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394