HomeMy WebLinkAboutPermit Building 1975-2-26
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PERMIT if 3 C/s--- L5
.iON HAs --BEEN APPROVED
NOTE:
NO PERM!'l
ILL BE ISSUED UNTIL--TRIS APPLIlc
APPLICATION FOR:
CONSTRUCTION ~
OWNER .-hl,. ",/;1,..5
MOBILE HOME I'
PLAN REVIEW
I
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tity Zip,
~O'(,.SJttIV411f' 11./'7: ~~tAt'. 1}t~;: . J '/1-1'(, I
ClLy . Zip
CHill~GE-OF OCCUPANCY
S"t -eLJ ~,
~
/W 0 }-rrl $ un
;\ddress
Phone
Name
I CONTRACTOR /ltJ II -e,. t t:.. ~; if#) {Je.# r II'" J'h ,J; ",4,
Name Address
Phone
O.S. REG. lI~tJ&D6tf.~ J~
\ 7 Range 03>
Twp.
Section
:it:{" I 4
Tax Lot oJ'-Itro
Code
Census Tract
"if v~d'D
Subdivision
Lot
Block
~d~~ J....&i"\
Property Acreage
Width
Depth
ACCESS TO PROPERTY (Road Name)
<t..7"l'
Existing Structures on Property:
Property Location - Address/Directions:
Below for Of f ice, Us e On1yXXXXXXXXXXXXXXxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
A ddt-\1 ~ J~' ~ I {,./ 0 IIBedrooms va4~o~':-'
, /
/'
/
Other
Communi ty I
Name of
SEWAGE DISPOSAL:
Site Inspect-ion II
Existing Sewage Disposal System ~
....
WATER ~PL.Y:
Well ':><' Spring
"
Public
Waste Disp.
Plumbing
Plan Review
PLUMBING t;s:
. I 1\ II
, . t
I Name /
~:::~ ~::::"iOO
PLANS TISHED . FACILITY PERMIT
_ftl YES I ~./ I I YES ~NO
S' ooouee of ^PPli,"~ ~~. ~
" ee Received By:~f ,Datjl::l-263
Bldg.
~,J. ---
PLUMBING:
Installed by
Other
FEES:
Mobile Home -
1% Surcharge
TOTAL
.3;(.
~t3;L
I~
I C/l CHECK
, Min. Septic Tank Capacity - Drainfie1d Required, - Lineal Feet -
Alo l>o....;t: at neW rcr;~t;-rudJoP7 ' tb j,e--"Qve--~
'5"cd..so.qr-. dBL1~' r'-tff'f9t,v,
v , " -
Maximum Depth
I
J~ nF exis6~
, ..-
./
Type of Construction 6 AI
Group
/
Fire Zone
Use Classification
B1dg Setbacks - from Center of Road Right of Way:
Front
~
Side Int~ ,~'
lO.i,de Exterior
..
Zone RA
--".:,..:.......;.
--:-
~NG: _
~ 1..,<,
". . ,-:-"-
DATE:
~@j~;.r'-if,f.' .
C~-DEPARTMENT OF ENVIRONMENTAL MANAG
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C55 - 12
LANE