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HomeMy WebLinkAboutPermit Plumbing 1995-6-23 NOTE: NO PERMIT WL BE ISSUED ~TiL THISAPPLICAT~S' - -- , PERMIT if \ ~\\ ...J\~ BE~N,APPROVED APPLICATION FOR: . CO\:,RUCTIO' ~ \ I MOBILE HOME I. ,LAN REVIEW CljANGE OF oecu, ANCY I I OWNER. Gb CJ... C GC" ') \ Q . , , C' Name~' " ---p"ddrr s., ~ City I, ' Zip ,Phone L\6 CONTRACTOR ~(""\~" y' C"ll"\'P ~'""("~,"€, ,-........'-'~~x~ OSOa..&II'k_ ./ "'- Na~e, ~, ~ress, ' " y , Zip Phone O.S. REG. '/I' ,. \..c8<1.. -\d..~ Twp. \ \\ Rangei..:;L ~ Sectio~ ~L\ ~~Tax Lot~ Code ,Census Tract ,~~ --/(fD Subdivision \,,\q \." '~. ( , . ACCESS TO PROPERTY (Road 'Name) , _1, ~b '- c:\'O-"""" ~ Existing Structures on property:~.p C. ( ..... \) , Lot Block Property Acreage Width Depth - , ~-\., . ( 0 ;r~Y ~~LD:"tic'~j{\:;l~ ~-=c,,~~~" . ~.~) ~~~--.. / / Below fo r Of f ic e Use OnlyXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX .... ~ { {, \ ( "- ~ Sq. Ft.. ~ IIBedrooms i\ V;9{~a7ion -----x~ V fV\ ".:-\ - Cto,-,:-\ (~;. 6r' ,---Yo ~..\_~ "'<.\Y\.. ~q~ Q) \l{" \0 ::t:io~( L ~ . \)', ~ / '/ / SEWAGE DISPOSAL:~ \ Site Inspection ac ,J)( \' ~ . Existing Sewage Disposal Syste~ Spring Other' I . Co~unity I Public, / ..' I or New System Required 'orne of C~Y 0' 'ub1'. Sy"em Bldg. 'Waste Disp. Plumbing Plan Revielo1 \-.\~~ PLUMBING: Installed by Owner '\ 'Water Connection Other 1% Surcharge- PL~~~S: , '\ \\ II of Fi~tures " ~t)1 ~,. . l..\n,~U LJLJ ~~ ", _ FACILITY PERMIT /- I l/, ES I ,I NO #' I "I?) IV I NO Sign ture of APPli~..-{1" '<f? ~ ~ Fe Received By: (~~ate:f--...\~\O~ Mobile Home TOTAL Type of Construction / . J / c5 AI Group DrainfiJld Required -'L neal Feet ~),.j, 1.., /6 ft." -f:" \ / / "j ~.! -Ve Zone Maximum Depth Min. Sep~~k Capacity , I.di::F-- ff<...eo n..eu) '-'" ........... V, >-95, Use Classification Bldg Setbac~s - from Center of Ro~d Right of Way: . Ii I / Front 00 Side Int. ~ I Side Exterior IV fla- t I Rear Ze Zone l~t~T C55 - 12 r../ '1-1' t; . I NE ' COUNTY SAmt: DEPAQ'CE:T.....OF ~ . '~l..-; ,~,U) U),I INN:G:: -I ~j ~,DA;E;'" ~ ~/':J' ~y~t. & ~/lP ENVIRONMENTAL ~NAGEMENT I' , ~Ql'L-