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Zoning Validation <br /> <br />F Property Owner ,. '] I Phone I <br /> <br />r Job Addr~S ~ ~2 / ,,., ~: ....... ~'" ~ '~- Site NO Cross Street <br /> <br />r-~- ~ I ~u ¢ ~~ Property Tax Lot No:: Fleet S,C Zo~ <br /> - _ .................... <br /> Subdvson ~ / ~ -- Lot / Bock <br /> <br />Mobile Home Park:: <br /> <br />Sp # <br /> <br />Total # Spaces:: <br /> <br />Secbon / r Township:: Range:: Zone Map ............ <br />Lot Width Lot Depth Acres Irreg Lot Corner:: <br /> <br />~~Name and~~ I Phon~ I A~reBs:: ' <br />A~hitect/Eng~n~?:: Phone / Address <br /> <br /> Type of Permit '-' New LI Addition:: ~ Demo:: <br /> Alter:: [] Relocation F0 Ccc Chg:: <br /> <br />~i~ht of Building NO Btorjes:: ~'~--Fi Main Floor <br /> <br /> Mobile Home Mobil~ Fi~n-e <br /> ¢' Bedrooms <br /> Width:: Length <br /> <br />Proposed Septic Installation <br />Previous Site Evaluation # <br /> <br />· Type Of System:: <br /> <br /> Test Holes Ready <br />Will call when holes ready <br />Existing Sepbc System <br /> <br />Existing Tank Size <br />Ex!_s_ting DrainfIeld Length <br /> <br />P_(o,.posed Bedrooms <br /> <br />Type of S~st_em: <br />Dale 'rank Pumped <br /> <br />Existing Bedrooms <br /> <br />Tach <br /> <br />Review:: <br /> <br />Sq Ft 2nd Floor <br /> <br />Occupancy <br /> <br /> Use Of Building ,0_ .,b~¢~, RES <br /> <br />/ - ~ , ,--..¢.~ COM <br />~ 7/-;Lx=~,t-/¢. <br /> Sq Ft Garage Other:: <br /> 0~CU~;nZL;:O_ ...... [_ Water Supply <br /> <br />OTHER PERMITS REQUIRED 8¥ THIS DF~T,:: PLUMBING, MESHANIS,~,L, E~EOTRIOAL <br /> <br />Valuation $ /-~--,.~,,.~'~,!.'__ <br /> <br />Mobile Home Fee <br />Fleet Surcharge % ,~¢ <br />Zoning Surcharge:: <br />State Surcharge:: ~ <br /> <br />Site Evaluation Fee:: <br /> <br />Septic Permit Fee ~ <br /> <br />DEQ Surcharge <br /> <br />Technical Review Fee % <br /> <br />Reinspection Fee <br /> <br />Investigation Fee <br /> <br />City Fee:: <br /> <br />TOTAL FEE:: <br /> <br />RECEIPT NO <br /> <br /> <br />