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Received Sy:~,?'~ .~:_~ ~'~ I~. IL'DING INSPECTION <br />ZoningValidafiom~~ ~ o ~t~220HIghSt~NE <br /> <br />Us.e~f Building'./ <br /> <br />Mailing Ad<~r~ss'. <br /> <br />Tax Lot; <br />Site No.: Cross Street: <br /> <br />Contract City: UGB: <br /> <br />Construction '1 Occupancy; Occupant Load; <br /> <br />Subdivision: <br /> <br /> Left I Ri ht <br /> Side: Si~e; <br />Lot; Block: Section; Township: Range; Zone: <br />Width: Depth: Area: Acres; Irreg. Lot: Corner;- Fleet SIC Zone; <br /> <br />MIn, Reqd, Front; <br />Setbacks: <br /> <br />Map; <br /> <br />Type of Permit: New: <br />.~-~Z. ~ 4 .<. r~_ .,,..,~ Alter: <br /> <br />~on No.: <br /> <br />Addition'. [] <br /> <br />Relocation'. [] <br /> <br />Demo; [] Tach. <br /> I ~ .... r~, I REs [] <br />o~, chg.: [] Ravtaw: [] ~'~ I L°,..~.__~ <br /> <br />Height of Building; I No. Stories: <br /> <br />Sq, Ft~ Mai'~Floor: Sq. Ft. 2n¢ Floor: <br />Length: Wet~y: <br /> <br />Address: .... ~_~ <br />Sq. Ft, Garage: ..,~ Other; <br /> <br />Proposed Septic Installation: <br /> Previous Site Evaluation #; <br /> <br /> Test Holes Ready; <br /> Will call when holes ready: · <br /> <br />Existing Septic System: Existing Tank Size: <br /> <br />Existing Drainfield Length: <br />Type of System: <br />Date Tank Pumped: <br /> <br />other ~-~ / ~ ' <br /> <br />Valuation; <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT,: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev. S/87 <br /> <br />Bldg. Fee: <br /> <br />Fleet Surcharge: <br />Zoning Surcharge; <br />State Sumharge: <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 />TOTAL FEE: <br /> <br /> <br />