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Zon,ng Valldalion <br /> <br /> Mailing Address <br /> <br />Site No <br /> <br />Property Tax LOt NO <br /> <br />Fleet S/C (~one <br /> <br />MObile Home Park .^ J ..' ....... , Sp,, ¢~,, <br /> <br />Section' ~ T~nshi~ ~ Range: I ~ Map:: <br /> <br />Lot Width , ~ ~ ~p~: ~ Acres rreg Lot C~eer;; <br /> <br />Block. <br /> <br />[Contractor Business Name andre <br />Architect/Engineer <br /> <br />Phone:: Address <br />Phone- Address: <br /> <br />Permit:' <br /> <br /> Height of Building ~ No Stories <br />'~~':__~ Moblie Home <br /> Length ~.:, <br /> <br />New:: Addition [~ Demo: [] Tech. <br />Alter- [~ Reloc. ation. [] O~c. Chg [] Review,~[]. <br /> <br />'Sq; Ft Main Floor. <br /> <br />Sq Fl. 2nd Fleer:: <br /> <br />Occupancy <br /> <br />Bedrooms <br /> <br />Use of Building RES <br />SCl Ft Garage: C~h~r <br /> <br /> Bldg. Foe <br /> Mobile Home Fee' J ~ <br /> Fleet Sumhar~ ............ <br /> ~ning Surcharge <br /> StAte Surcharge: <br /> Plans C~ck Fee- <br /> <br /> ~ Permit ~e <br /> <br /> DEQ <br /> <br /> C~y Fee <br /> <br /> Proposed SePtiC <br /> Pfev,ou~ Site Evaluation <br /> Type of <br /> <br /> Teat ~ Ready' <br /> <br /> ~istin~ Orainfleld Length <br /> <br /> Date Tank Pumped M-~/~/ E~ng ~drooms: ~ ..... <br /> <br />~HER PE~IT$ REQglRED BY T~IS ~EPT.: PB~BINS, MECHAN~ELECTRICAL <br /> <br /> <br />