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Date Received <br /> f Phone.Contact for Permittin -., '$ �2te <br /> 2LLztxmrmSEtt <br /> rMT <br /> 71 <br /> Owner's Names Owner Phond,blUrhber_ -72-7- 7-YG 9 <br /> Owner's AdrlriasE1 l., .0 f�� LAXI"L V-Pone Owner Phone Nu i ber C_ <br /> Fes airnpie 1'ltisitolder Name ! Owner Phone Alai kter <br /> Fse tilmpie 1'itiet older Addresei <br /> JOB ADDRESS I i LAta,R,� <br /> SUBiDIVISiON C-� —� PARCEL 10#C_ <br /> (OBTAINED 1:I10M PROPERTY TAX NOTICE). �- <br /> WORK PROPCiSEzO I NEW Ct)NS1'R ADD/ALT Cr,1 S1C3N (_ '. C( DEMOLISH <br /> El" ! INSTALL. REPAIR <br /> PROPOSED USE! C i SFR; (� OOMM- [_.� C)'THER, �_ I <br /> . .._.� <br /> TYPE OF( ON;STRtaC'rIG!N C� - BLOCK FRAME. C STEEL <br /> DESGRIPTION Of WORK C!?CPtp. 0,�.�r_ �s' a^►�Siie: _� 201'��.:f` _�_.� <br /> 3UILDING SiZlc 15Q FOOTAGE—,� HEIGHT <br /> z>=u�su�aaa�a�r�cr�z��uct� I�r..uxa:t�i�ca� c�cuius� rr.>+sr� �aa�uri�rasz�ucz�I� <br /> [4BUiLDINt1 VALUATION OF TOTAL CONSTRUCTION <br /> [_7i„LECTFilOAl. $ AMP SERVICE, . ORO�_RESS"ENERGY,: �„ W.R.H.C. <br /> [r7PLIJMBii, G ($ I <br /> [.__1MECHANICAL ($ VALUATION OF MECHANICAL INSTALLATIC)N= <br /> GAS !; ( ROOFING [� SPECIALTY'C_] OTHER <br /> INISHED FLOOR ELEVATIONS FLOOD ZONE AREA =]YES , NO <br /> ti t ti-ttl t f-hi f-Httii-H tttt tttttt Fti fi ti-i t ft t fi ti-tfittti H H ltlth1 t H t f t i ti t t t t-F•Hf•t4+ t•tf+t H•f•t-H•i <br /> UILiDER ()MPANY _rE <br /> IGNATURI. �_'�tt� t►pNi�1 C� tao r . REGISTERED Y/ F1'E CURREN I Y/N <br /> ,Address 4 iRe)_sp)L 19 9 3 41 A j 2.761 Licari.,e# G�.s o y!7 _..� <br /> _EC:1'RICIAIV _ ._.._�. COMPANY' <br /> GN.ATURr-.' REGISTERED YIN T FEE CURREC` Y/ <br /> Address —._ _� —_•_ License# <br /> i <br /> .UNI13ER COMPANY <br /> MATURE; _ _ REGISTERED Y/ N 1 r."EPEE CURREN Y,/I <br /> Address . License <br /> "COMPANY <br /> 3NATURE REGISTERED Y/ N FLE cURREh Y T F <br /> Address [_�--•_-Y-_� _ License# <br /> HEiFt 'I COMPANY („_ �_�_ <br /> ;N,ATURE _ _ REGISTERED Y./ N !r FEE CURREN �[ Y/N� <br /> Address —_ -- LicensE�# <br /> NiittH+tiFi httti}itt�i�ii H ti hf hH+tt 111 f 111 111 IM+H i-f+Ftf t H+1+1tFtittii �ht-F tt t t t-t i-t+Hii tiiiitill i t hFiiif4tti <br /> SIDIENTIAL, Attach(2)-Plot Plans;(2)jsets of Building Plans;(1)set of Energy Forms;R-O-W Permit foi•new construction, <br /> Minimum ten(10)working days rafter submittal data. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> 11a rift iry Facilities&1 duinpster,Site Work Permit for subdivisions/large Projects - <br /> _rIIAERCIAt.- - Attach(3)complete sots-af-Building Plans-plus-attte-Safety Page;(lYset of`Ehergy Fotms.`R=O•W Permlffor new CbnstructlOn. <br /> Mfnlmum ten(10)working days after submittal date. Required onsite,Construction Plans,.$,tormwater Plans w/Slit Fence Installed,. <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All;commerclal requiriements must rneet,compliance <br /> N PERMIi' Attach(2)sets of[Engineeired Plans. <br /> """PROPERTY SURVEY required for all NEW construction. <br /> �=zrua:�x.�azE:txr�raa>�aa��cizc�zra�a�x�r.�E:i�rs�zizr�p�a.a �'m(uat: xtzk. <br /> fictions: i <br /> Fill out application completely.. <br /> Owner&Contractor sign back of application,notarized <br /> tit over$2 501),it Notice of Commencement ls.requlred. (A/C upgrades over$7600) I <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> :R.•rHE COUNTER PERMITTING (Front of Application Only) <br /> lofs If shingles ; Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter If on public'roadways..rieeds ROW <br /> j I <br />