Laserfiche WebLink
Situs Address: <br /> <br />Use of Building: <br /> <br />Mailing Address; <br />Lot: ~" I Bloe~, ~.. I Section; /I Township: <br /> <br />Tax LOt: <br /> <br />Bite NO.: <br /> <br />Cqptract City: UGB: <br />Construction Type: Occupancy; <br /> <br />Min. Reqd, Front; <br />Setbacks: ~ ~ <br /> <br />Range: <br /> <br />Irreg, Lot: <br /> <br />Occupant Load: <br /> <br />Left Right ~ Rear: <br />Side: ~ Side: <br /> <br />Zone: Map: <br />Comer:~ Fleet SIC Zone: <br /> <br />Type of Permit; New: [] Addition: [] Demo: [] Tech. <br /> <br /> Alter: [] Relocation: [] Occ, Chg,; [] Review; [] <br /> <br />Phone: <br /> <br />Uae of Buildlng; <br /> <br />Address'. <br /> <br />RES [] <br /> <br />COM [] <br /> <br />Home Builder's Registration No.: <br />Architect/Engineer; Phone: Address; <br /> <br />Height of Building: NO. Stories: Scl, Ft. 2nd Floor; Sg, Fl, Garage: Other: <br />Mobile Home: Width: Water Supply; <br /> <br />P~opeced Septic installation'. <br /> Previous Site Evaluation #: <br /> <br />Bq. Fl, Main Floor: <br />Length; <br /> <br /> Type of System; <br /> Test Holes Ready: <br /> Will call when holes ready: <br /> <br />Existing Septic SyStem: <br /> Existing Tank Size: <br /> Existing Drainfield Length: <br /> Type of System; <br /> Date Tank Pumped: <br /> <br />Valuation; <br /> <br />$ <br /> <br />Bldg, Fee; <br /> <br />Mobile Home Fee; <br /> <br />Fleet 8urcha~je: <br /> <br />Zoning Bumharge; <br /> <br />State Surcharge: <br /> <br />( ) I have reed this apolication In Its entirety a~d certify that the stated information <br /> is true and e, ormet to the best of my knowledge. <br />( ~ I am performing work on a property I own or occupy, <br />( / I am a ~egiste~ed builder OR ( ) the authorized repre~enl;~tive of e registered builde~ <br /> TSe work will be performed by a registered buildec <br /> Other. <br /> I agree to build according to the submitted plans and specifications, the lawS of <br /> <br />OTHER PERMITS REQUIRED BY THIG DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev. 3/87 <br /> <br />Plans Check Fee; <br />Site Evaluation Fee: <br />Septic Permit Fee; <br />DEQ Bumharge: <br />Technical Review Fee; <br />Reinspection Fee: <br />Investigation Fee: <br />City Fee: <br /> <br />TOTAL FEE: <br />RECEIPT NO,: <br /> <br /> <br />