Laserfiche WebLink
9ubdMsion: <br /> <br />Mobile Home Park: <br /> <br />Property Tax Lot NO,; <br /> <br />Cre.~s Street; <br /> <br />Fleet S/C Zone: <br /> <br /> Lot; Block; <br /> Sp. #: Total ¢~ Spaces: <br />Section; Township: Range; Zone: <br /> <br />Lot Width: <br /> <br />Lot Depth; <br /> <br /> t Mep: <br />Irreg. Lot'. Corner'. <br /> <br />:~ctor Business Name and NO.: <br /> <br />Address; <br /> <br />Addrese; <br /> <br />,~,¥~e of Permit: J New: ~ Addition: [] Demo: [] Teoh. <br /> <br />Alter; [] Relocation: [] eec. Chg.: [] Review: [] <br />Height of Building; <br /> <br />Uee of Building: <br /> <br /> No. Stories; Sq, Ft. Main Floor: Sq. Ft. 2nd Floor; Sq. Ft. Garage; <br /> <br />Mobile Home Mobile Home '¢ Bedrooms: Occupancy; Occupant Lead: <br />Width; Length: <br /> <br />Proposed Septic Installation: <br />Previous Site Evaluation <br />Type of System'. <br />Test Holes Ready: <br />Will call when holes ready: Proposed Bedrooms; <br />Existing Septic System; <br />Existin(l Tank Size; <br /> <br />~_,Exletlng DrainfJeld Length: <br /> Type of System: <br /> <br />Date T,a, Ok Pumped; <br /> <br />Exlstin¢~ Bedrooms: <br /> <br /> have read this application in its entirety and certify that the stated information is <br /> <br />The work will b~ pe~r. formed by a j[egis~jed .~uilder I~ <br />the.t.teofOrego, af~dtheordi aao,sofM,do, Co ry. ~/~~ <br /> <br /> RES <br /> <br /> COM <br /> <br />Other; <br /> <br />Water Supply; <br /> <br />Valuation: $~-.~:~: -~--. <br />Bldg. Fee: $ /~¢. ~'~ <br />Mobile Home Fee: <br />Fleet Surcharge'. <br />Zoning Surcharge: <br />State Surcharge: , c~<~_ ..... <br />Plads Check Fee: ~-~<~ .... <br />Site Evaluation Fee: <br />Septic Permit Fee; <br />DEQ Surcharge; <br />Technical Review Fee: <br />Relnepection Fee; <br /> <br />investigation Fee; <br />City Fee: * "~"~/? <br />TOTAL FEE; <br />RECEIPT NO.: <br /> <br /> <br />