HomeMy WebLinkAboutPermit Building 1974-4-30
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LANE COUN BUILDING PERMIT cJ\MOBILE He USE APPLICATION
PER~IT TYPE - BUIL~,ING X MOBIL~_n':iOME f: OS~ REG # 23,'1/ .., .!ERMIT:zt_ t If' - ? t..[____
PROPERTY.OWNER 'I MAILING ADDRESS _ ~ PHONE'
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%~Y LUl...ATlON _ INCLUDE POST OFFICE ~'n
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17 }3GE ___,.J~ ___,__.__ :~~ ~OT # CODE ___n ,_ C~L ~R/~ ()
^,:'~~:NT ~ ~~. DESCRlB' EXISTING TRUCI"''' ON PROPERTY IF ANY
AND
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MAILING
ADDRESS
LEGA.L~~ -,:OAD N_AME OR #
PROPERTY SIZE-WIDTH DEPTH
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AREA
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
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Connect to EXisting Sewage System =:J
TYPE CONSTRUCTION SQ FT
or New System Req 0
#: BEDROOMS VALUATION
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BLDG
WASTE DIS
PLUMBING
PLAN REVIEW
PARK TRLR
$
SEPTI~_~_, ",OTH_E~_p ,
7 () () FEES WATER SUPPLY
PUBLIC ~
PI&~G FEES
FIXTURES
PLUMBING INSTALLED BY
SEWAGE DISPOSAL
PUBLIC 0"
TOTAL
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PUBLIC WATER
CONNECTION FEE
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MIN SEPTIC TANK CAPACITY
WITH DIST BOX GAL
TYPE OF STRUCTURE
i/
OCCUPANCY
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ZONE
REAR YARD
PUBLIC UTIL EASEMENT
BLDG SETBACKS - FT FROM CTR OF ROAD RIGHT OF WAY
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USE CLASSIFICATION
FR~\\IAN SIDE INT
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qectlons to Find Property",
SIDE EXT
PLANNING
Date
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COPY 1 - OFFICE
~COPY 2 - JOURNAL
COpy 3 - AUDIT
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