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Received By; ARION. COUNTY BUILDING INSPECTION City Setback Requirements; <br />City ' ,¢':.-.--~ / ~¢~-~ __ Senator Bldg. No. 225 / ~-rom;- ' / . ~Rear; <br />ZOning Validation~ .~ ~ 220 High st~ NE I ~rom; ~ <br />Data; /~-~/~ ~ ~1 ~/ ~ ~ Phone~s8.~141 I~;~; ~' Sde; ~/ <br /> <br /> Prop~ Own~ ~,~ ¢. Phone: Mailing Acdre~: <br /> <br />Job Address; <br /> <br />Subdivision: <br /> <br />Mobile Some Park~ <br /> <br />Property Tax Lot NO.: <br /> <br />Lot; <br /> <br />Sp, <br /> <br />Cross, Street: <br /> <br />Flaa{"~TC <br /> <br />Block: ¢ <br /> <br />Total # Spaces; <br /> <br />Lot Width: Lot Dap,h; / Acres: <br /> <br />C~/~¢tar Bu~lz3,ess Name and No,; <br />Architect/Engineer: ¢' ': · <br /> <br />Type of Permit; /~l New; ~ Addition; <br />~/~ ,~,/.~/Y'~-C~ ~ Al,er: [] Relocation: <br /> <br />Height of Building: 1'~ / <br /> <br />Mobile Home <br />Width: <br /> <br />Demo: [] Tach. <br />Oeo. Chg.; ¢'~ Review: [] <br /> <br />No. Stories: <br /> / <br /> <br />Mobile Home <br />Length; <br /> <br />Sq. Ft. Main Floor; <br />........ _,,:. <br /> <br />Sq, Ft, 2nd Floor: <br /> <br />Use of Building; <br /> <br />Sq. Ft, Garage: <br /> <br />RES ~ <br />eOM I'~ <br /> <br />Occupancy: Occupant Load; <br /> <br />Other; <br /> <br />Water Supply; <br /> <br />Valuation: <br /> <br />Proposed Septic Installation; <br />Previous Site Evaluation #: <br /> <br />ZY~..¢_,S.Y~ter~: <br />Test Hole s~R,.e~i <br />Will ~all when hales ready: <br /> <br />Existing Septic System; <br />Existing Tank Size: <br /> <br />Proposed Bedrooms: <br /> <br />Existing Drainfield Length: <br /> <br /> Type of System: <br />~:i~'~lPs ii:plication in its er~tirety anl i i~ttil i~ t iltl r~i information is <br /> <br /> builder. <br /> <br /> O~her <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev. 12/87 <br /> <br />Bldg. Fee: <br /> <br />Mobile Home Fee; <br />Fleet Surcharge: <br />Zoning Surcharge: <br />State Surcharge; <br />Plans Check Fee: <br />Site Evaluatlan Fee; <br />Septic Permit Fee: <br />DEQ Surcharge; <br />Technical Review Fee: <br />Reinspection Fee; <br />Investigation Fee: <br />City Fee; <br /> <br />TOTAL FEE: <br />RECEIPT NO,; <br /> <br /> <br />