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City ~ / <br />Zoning velida~ <br /> ~/l.)~% ~UILDING INSPECTION <br /> <br />~)UNTY BU!.LDING INSPECTION <br /> <br /> 220 High St'eat NE <br /> <br /> City Setback ,Requiremen,ts'. <br /> r <br />Front: 7-~-~:) fl Rear: <br /> / <br />Left ~/IHight <br />[Side; "~ I Side: <br /> <br />BUILDING [] MOBILE HOME [] SEPTIC [] PERMIT APPLICATION <br /> <br /> Property Owner: ..... Phone; "Mailing Ad'Sress: <br /> <br /> Job Address:~ Site NO.: Cross Street: <br /> Property Tax Lot NO.: Fleet $/C Zone: <br /> Mobile Home Park; Sp, #: Total # SpaCeS; <br /> <br /> Section: Township: Range; Zone: Map: <br /> <br />'"Lot Width; Lot Depth; Acres: Irreg, Lot: Corner; <br /> Z.~% ~-~ <br /> <br />Contractor Business Name and No.: <br /> <br />Arch[tect/Engiceer: <br /> <br />Phone: <br /> <br />Phone: <br /> <br />Address: <br /> <br />Type of Permit: <br /> <br />Height of Building: <br /> <br />Mobile Home <br />Width: <br /> <br />N~: [~' Addition: [] Demo: ~'1 <br /> <br />Alter; [] Relocation: [] Oct. Chg.; [] <br /> <br />No. Stories: Sq. Ft. Main Floor; <br /> <br />Mobile Homo # Bedrooms: <br />Length: <br /> <br />Tech. <br /> <br />,~1- Ft. 2nd F]cer; <br /> <br />Use of Building: <br /> <br />SCl- Ft. Garage: <br /> <br />RES E] <br /> <br />COM [] <br /> <br />Occupancy: Occupant Load: Water Supply: <br /> C., t-r'/,,, <br /> Valuation: $. <br /> <br />Pmpos~:~l Septic Installation: <br />Previous Site Evaluation ~: <br /> <br /> Type of System: <br /> Test Holes Ready; <br /> Will cell when holes ready: Proposed Bedrooms: <br /> Existing Septic System; <br /> Existing Tank Size: <br /> Existing Dralnfield Le,ngth[,. <br /> TT~:~e of System: <br /> Date Tank Pumped: Existing Bedrooms: <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br /> <br />Bldg, Fee: <br />Mo~ile Home Fee: <br />Fleet Sumharge: <br />Zoning Surcharge: <br />State Surcharge: <br />Plans Ch~ck Fee: <br />Site Evaluation Fee: (~ "~.~ *~'~ <br /> <br />Techn[~l R~ <br />~ins~ion F~: <br />in~stig~ion ~e: <br />City ~e: ~ .OO <br />~TAL FEE: <br />RECEIPT NO,: <br /> <br /> <br />