Laserfiche WebLink
�;PP'. �n?, i�OR C�c�I' 7'�_9G � �hb1IT <br />--- - ...- - -- -- - <br />DATE ��� / 9 7 � <br />:� <br />i <br />NAME G.�.-- ����.�------ — _ <br />ADDRESS ? �.;� ��__�z[a.�:si-----� �c�. L�..-�•• ZI P CODE -rj 4,2 ?�_ <br />HOME OWNER BUILDER OR CO�TRACTOR <br />ADDRESS__ _�2�•���[��.J�.� �IP <br />J <br />CONTRACTOR'S LICENSE r_______.___._.__ <br />PHONE \-�.l 1 -�,�- _ <br />EWAGE PERh1IT = L�O cw-� <br />DESCRIPTION 0= BUiLD'1tiG��� j 1YPE Of HEAT <br />� DRIVEIJAY PERMIT � <br />ADDRE55 �'� ..�W BUILDi��.G!_ _..`___---_-�----- �JIDT'I OF ROAD <br />���,o�;�Y,y�:�1�1��?��J1G-�!�1!_-�1/?I?�?ZL�� .,�:L ; <br />L�GALT]ESCRIPI IOY: � / <br />\ ti � <br />SUBDIVISION��Y�„��\.s��.: Z�'�� _6LOCK__�^_LGT ' L' ' _ <br />LOT SiZE Sp X/�1 D SEC. `ZQ TWP._2� _RGE.�_16th SEC. _ <br />MEETS OR BOUNDS <br />� <br />MAIN FLOOR DIMENSIONS <br />STORIES BASEM[NT <br />DIMENSIONS OF GARRGE __ CARPORT_ <br />DO NOT INCLUDE GARAGE OR CARPORT IN '�HE fOLLOWING UNLE,�S GARAGE IS IN BASEMENT. <br />SQ. FT. MAIN FL <br />PLAN N0. <br />SQ. FT. ON SECOND FLOOR_ _ ___ DASIC M0. <br />SQ. FT. IN BASEMENT ( I�ICLUDE GARA6E 1F LOCATED IN BASEMENT ) <br />THE ABOVE ?ROPOSED S�iRUCfURE IS TU B[ USED FOR THE fOLLOWING PURPOSE: <br />HAS CONS7RUCTION S"iNRTED? STGNED - HOMEOWNEIt_��.�� �.� y. <br />YES NO_�`� <br />COiiTRACTOR _ <br />IC SE 0 Y: <br />VALUATI ON -Y <br />��� ,z��) �S �' <br />PERMIT FE��-,���`'"`'.�-- <br />PLAN CH[CK F[E _______ _ ___ ___ <br />BUILDING PERh1IT NUMBER <br />PLaN �HECK MUST BE PAID WHEN <br />Pi-'-'IS .4RE SUBMITTED <br />