HomeMy WebLinkAboutPermit 330B12
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Applicant, (If other than owner) Nome, _._~,c::.-~-L:.:c:n:'~'--.mm..mnnm--n.-m-m-n,'m,nnn,nmmmnUmmnmm_'m,nmnnnm_
Address, nm_.nmnm_mnmnmnmnn_n_u___:,_m:mT7__n~m,.__mnm:nnnnm__.%.m.~-,z:;.;;;;.;;- !,~ney;' _;_~_;;;';;nnm;'mn__nn
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ne a ove app lcant app les or a permit to,...{u___m__mn_______._~.u__________________~___________ __/__m___u_n___nnumnn .------------,r-u_----------
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lE!uild, alter, repair, wreck _ as case may be) ..~,f> -" _
PERMITS APPLIED FOR, ICheck those opplicoblel BUILDING (Estimoted Costl mnnmnm_,c:n~::n:L:'_~__mmmnnnnmnnmnnn
IND, SEWAGE DISPOSAL SYSTEM, _mn_"':'/,n_';c~:nnnm-.n-nnnn-mnnn'-mm,
KIND OF CONSTRUCTION, ,;,-!_<___^u:__!4/.:'.::'u:::E_L~;:;:~;::::::::::_:::::::::::::::::::::=::::::::::~::=~_:-.~~:~::::,~::::::_-::::::::::::::::::::::::::_
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Number of Bedrooms: .._..h........U_..-=-:'?___uu_____n_____nnn___n._..___. General Contractor: _-n!::-~--:~./~~:..~~.::..h..-----n.----..---.---nn-n.--..-..-_
Lega I Desc,i pti ~n! ~, Property, m--.--nm---;.nn--u-m.nmi.:z:::-----n-----n-;-ru-n-.m.u,u_-ru.:'_ --n-uu._--._-:h-m':.~'-u-n-.-.--:-.;-:-il...-I!
Townsh,p,mu__nhn,mmm.h__ Section, n/-_km Range, n nmm_ or Lot, h__'1.._m Block, ___mnm_ SubdivIsion, Ld_!_'h'nm___.' ._ _
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Zoning District, Agricultural, _mhh__n__.Umnn Residentid m_~m-___ Commerciol,m__mnunun_m Industriol,mmnu.mm____.
A Plot Plan showing the following must accompony this application,
1. North Direction 5. Street name or road number
2, Location of Proposed structure on lot 6. Locations of existing structures
3, Dimensions of front and side set-back 7, Location and size of Septic Tonk and Dfainfield
4. Dimension of structure IsJ 8. Location of well-Distance from Septic Tonk and Drainfield
Applicant hereby agrees that, in case above permit is granted, that 011 work sholl be done and all materials which shall
be used shall comply with the plans and specificotions herewith submitted and with the Ordinances of Soid Township
and County applicable thereto. ',' '. /f '-''- / /',. ,/" , . U , .:;.,~ / '7/
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TOWNSHIP USE ONLY ,
Recommend Approval, nunm_~mm____.nh Recommend Disopprovo!' _mnnm__mm__.hnm_hn__n Approval recommended
subject to the following conditions, m_h_mnmmmmm_.mumnmunnunnmmnm_.mhnh____.hm____n'Onnm.m.nh___nn.nnnnnnn.mnmm
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/ . COUNTY USE ONLY. . . , .
Approved, unm_m.mmn DeOled,mnm_mm__n, By PlonOlng and Zoning Coordinator sublect to eXlStlng regulations and the
following cond itions, ._.,nmmU_'.nn_nm'_n_n__n_'u_'m_nu.um_u_unn_____mn____m____mn__mn__m.mh__..n._mh.UUmn_'_nnn__nm_n____m__,
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FEES PAID,
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BUILDING PERMIT nn__ t -~'
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IND, SEWAGE DIS. 00__ / ':/
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WELL mmU___hm.mm... . -I- ;7. .(' (i /:< 9
TOTAL FEE .h.__dd ~ 'l/. RECEIPT NUMBER,m..mdh.m'mm.?mmuhnhn
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INSPECTIONS,
FOUl NO, ,
1Rev. 11-14.69)
1. COUNTY COPY