Laserfiche WebLink
"' A293031 � pro ert Tax Accqunt No. �i �� / " -n�� � ���'��� <br /> Sno �h Healtl4� trict P y � <br /> E�� ��, eal Division � .. �� ���„ <br /> � hous�e;� rett�WasMngton Plan Check No. <br /> 2 �947�`'t,� � to <br /> � ����'��y� o <br /> PlOT� 'REVIEW PROCESSING FEE OF E20.00 IS PA1fABLE UPON 15SUANCE OF THE BUIIDING <br /> - 9�lP�j �t�� . <br /> CLEARANCE for Construction with Existing On Site System z <br /> Owners Name: /�Pi� / � �r Phone:�e: � -�7'�RS � <br /> Site Address: ' � �-� � r• / `— �� m <br /> Contact Person:_ ��„� �i�cr P (o�����nIPhone: ��'s�/ ' ����� - � -- <br /> J / C / [y r� �--� T <br /> SrSJL. —1. � ��Vr /I/ �F iCL' 1ft"4CnS /��J 8 •.•-� <br /> Contact Person's Address � N = <br /> . v m <br /> Site Legal Description/Lot No:: t ac ong ega "� <br /> � <br /> Explain Pro,�ect and its use: (Room addition, garage, barns r•eplacing`obile home, o m <br /> • 7emporary Conditional Use) �� m� <br /> O Z <br /> C <br /> n -i <br /> rx <br /> Indicate total number of bed�•ooms before and after construction: ,J <� <br /> RTTACH COPY CF PLOT PLAT: 8�," X 11" minimum showing: �m <br /> 1. Oimensions of property lines 5. Roads, easements, driveways, parking m� <br /> , areas o N <br /> 2. Dimensions of exlsting structures and 6 ��� location <br /> their distance to lot lines. m� <br /> 3. Dimensions of proposed construct{on 7. North arrow �� <br /> . m <br /> 4. Location of septic tank and drainfield,, A <br /> if known. D• <br /> SEWAG[ SYSTEM "as-built" DRAWING INFORMATION: � <br /> Ilomes Constructed after 1977, Property tax account n�nnber used. _ <br /> Huines Constructed 1955 to 1977: Provide: Name of Builderi � <br /> or Name of First Owner , and Year of Constructi� � <br /> Applicant Slgnature: � � �'— m <br /> DO NOT WRITE BELOW THIS LINE �, � <br /> 3_ �_4 ; '��xy;�� ��,��:��._�c�v�ac�y ci.,:c�. ��o�� �'F1� �<,� �`l�q.,���c�c� , i <br /> REMARKS A'S � �`` g�� , <br /> - 4 � � a <br /> . <br /> . a <br /> • �, e� -� C �.[� \ a • ' � Qr <br /> �„�« Oate:�-��- � — <br /> k �c.. ,, �enied by - .� <br /> �. Date: - 5� '��i � <br /> � � � , . <br /> c�.��f �Proved by��� . � _: J�i. � .._._ ---- . -- <br />