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Received By <br /> <br />City~ Validaeon <br />Zoni.g ' <br /> <br />BUILDING [] <br /> <br />Job Address <br /> <br />~lJbd~vis,on <br /> <br />Mobile Home Park <br /> <br />Section Township <br />Lot Width Lot Depth:; <br /> <br />Archite~/Engineer <br /> <br /> COUNTY BUILDII~II'~I:f]E~IQN~r? ~'ItYP¢~ask Requiremem~ [ ,,h <br /> <br /> 220 H gh St~et . ~. <br />MOBILE HOME ~EPTIC~D~~ATION- __ __ <br /> <br />Range:: <br /> <br />Site NO Cr.~ss Street <br />Property Tax Lot No:: Fleet SiC Zone:: <br /> <br />Lot -- <br /> <br />sp#: // <br /> <br />Block:: <br /> <br />Total # Spaces <br /> <br />Phone '"'~ Address ~'/~-1 <br />Phone <br /> <br />Type of Permit I New [;P"/ Addition:: [] Demo L~ <br />/JCe'b~/¢4 lA,tee [] .e,ooatian:: [] ccc rhg ra <br /> <br /> Height of Building . No Stories Sq, Ft Main Floor <br /> Mobile Home Mobile Home ¢ Bedrooms:: <br /> W~dth ~ / Length ~--~ / ~ <br /> <br />Review:: <br /> <br />Sq Ft 2nd Floor <br /> <br />Use of Building <br /> <br />Sq Ft Garage:: Other <br />Occupant Load <br />Valuation $ <br /> <br />~Es ~ <br />COM [] <br /> <br />Proposed Septic Installation:: <br />Previous Site Evaluation #:: <br /> Type of System <br /> <br />Test Boles Ready <br />Will call when holes ready:: Proposed Bedrooms <br /> <br /> Existing Septic System <br /> Existin~ Tank Size <br /> Existing Drainfietd Length <br /> Type of System <br /> D_at_?,,,,iTa~ I~ ,, ? m p ed :: Existing Bedrooms <br />~1 have reed this application in its entirety and certify that the stated information is <br /> <br />~HEB ~ERMITS REQUInED BY T~ DEPT.: P~MBING, MECHANICAL, <br /> <br />Bldg Fee <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 />OEQ Sumharge <br />Technical Review Fee:: <br />Reinspection Fee <br />Investigation Fee <br />City Fee <br /> <br />TOTAL FEE <br />RECEIPT NO <br /> <br /> <br />