Laserfiche WebLink
City ~. Senator BIdg NO 225 Fr nt / Rea / <br />~ = ti , t~ I1,,]} Cod~A-Phone 4;80 ~M,- 8::00 A,,M,, ~ -- <br /> <br /> [ ~.' i/ ~ ~ B~ING ~ MOBILE HOME ~ SEPTIC ~ PERMIT APPLICATION <br /> <br /> ...... <br /> <br />Mobile Home Park <br /> <br />LOt Width:: <br /> _¢,/', <br /> <br />Site NO <br /> <br />Property Tax Lot No <br /> qo- DO <br /> <br />Lot:: <br /> <br />Sp ~ <br /> <br />Total ¢ Spaces <br /> <br /> Type'~-Fermit / New"--~'~"A~diii~ "~ ....... [:)~o:: Iq Tach <br /> <br />~r~ ~ Alter ~ Relocation 0 Occ Chg :: 0 Review <br /> <br /> WidthMobileHeight~/ ~ of Home Building ~ /~t Length Mobile No, /St°ries:;Home [ '~'~,/~0 Bedrooms ~] '~i~ '~[o~r ~ .... Occupancy Sq, Ft 2nd Floor <br /> <br />Use of Building RES <br /> <br />Sq Ft Garage Other:: <br />Occupant Load W~.,pply <br /> <br />Proposed Septic Installation:: <br /> Previous Site Evaluation ¢;: <br />Type of System <br />Teat Holes Ready <br />Will c~l! whe_n..h~!~s_.r~c[y_ Proposed Bedrooms <br />Existing Septic System:: <br />Existing Tank Size <br /> <br />~Exi~!!e¢_ Or~in[!¢¢ Length .... <br />Type of System <br /> <br /> Date Tank Pumped Existing Bedrooms:: <br /> ~1~ I have read this E~ppltcaPon in its entirety and certify that the stated irlfor~atioA is <br /> true and correct to the best of my knowledge <br /> I am performing work on a property I own or occupy <br /> <br />SIGNATURE OF APPLICANT ~-' '(-'~-- ~ ' <br /> <br />ELECTRICAL <br /> <br />MC 15-6 <br />Rev <br /> <br />Mobile Home Fee <br />Fleet Surcharge .,-~.- ~ -/~-- <br />Zoning Surcharge ........ <br />State Surcharge /~). -~-~--_. <br />Plans Check Fee /---'~--~-,_.,'"~',-~ <br />Site Evaluation Fee <br />Septic Permit Fee <br />DEQ Surcharge <br />Technical Review Fee <br />Reinspection Fee:: - <br />investigation Fee:: <br /> <br />Ci,y Pea:: <br />TOTAL FEE ~"'~/~'~ <br />REOE,PT NO <br /> <br /> <br />