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Site No,: <br /> <br /> Section: I Township; <br /> / <br />5 , <br /> <br />ir . LOt'S'" <br /> <br />Corner: <br /> <br />,., / Fleet SiC Zone: <br /> <br />Use of Building: <br />Addr~e: <br /> <br />Home E~uilder's Registration NO.: <br /> <br />RES X <br /> <br />Architect/Engineer: I Phone: I AddreSS; <br /> <br />Helght Of Building: , Ho. Stories; Sq. Ft. Ma~n Floor: <br />Mobile Home', Width: Length: <br /> <br />P~posed Septic <br /> Previoue Site EvaJuatio~ <br /> Type ct System; <br /> Test Holee Ready; <br /> <br />WiII call when holes re,a~l~,: <br /> <br />Existing ~eptic System: <br /> Tank Size: <br /> F~lstlng Oreinfield Length; <br /> Type of System: <br /> <br />Dele Te, nk Pumped: <br /> <br />Sq. FI. 2nd Floor: Sq. Ft. Gar~g~i ' <br />Water Supply: <br /> <br />Value.n: <br /> <br />$ <br /> <br />Other: <br /> <br /> ~ ~ue and ~r~ ld ~e b~t of ~ ~1~, <br /> <br /> I ~ a tugS,red built OR ( ) t~ ~u~ ~p~a~ of <br /> <br />OTHER PERMITS REQUIRED BY THI~ DE~: PLUM~ING, MEOHANIC~ EL~ICAL <br /> <br />Bldg. Fee: <br /> <br />Mobile Home Fee; <br />Fleet Surcharge; <br />Zoning Su nr,,harge: <br />State Sumharge; <br />Plans Check Fee: <br />Site EvaJuatton Fee; <br />Septic Permit Fee; <br />DEQ Surcharge; <br />Teghei~.al Review Fee: <br />Reinspect~on Fee: <br />investtga~ldn Fee: <br />City Fee: <br /> <br />TOTAL FEE; <br />RECEIPT NO.: <br /> <br /> <br />