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HomeMy WebLinkAboutBLD2006-00332 9ILDING PERMIT APPLICATIRN ML vy 313 Review T Type: I Jefferson County Department of Community Development 621 Sheridan Street Port Townsend, WA 98368 PERMIT #: BLD06-00332 Received Date: 6/12/2006 SITE ADDRESS: 114 MAPLE AVE BRINNON, 98320 OWNER: WILLIAM L OSKAM PHONE: (360) 796-0162 MAYE DONNA OSKAM 114 MAPLE AVE BRINNON WA 98320-9602 DUPUIS SHORT PLAT SUBDIVISION: Block: Lot: 4 PARCEL NUMBER: 502313049 Section: 31 Township: 25 N Range: 02 W CONTRACTOR: OWNER/BUILDER PHONE: REPRESENTATIVE: PHONE: PROJECT DESCRIPTIOr DEMOLISH EXISTING MANUFACTURED HOME TYPE OF WORK MOB SQUARE FOOTAGE: TYPE OF IMP DEM MAIN: VALUATION ADD'L: HEAT TYPE: CODE EDITION: 2003 HEAT BASE: HEAT TYPE: OCCUPANCY: UNHEATED: #OF STORIES: OCCUPANCY: OTHER: CONST TYPE: GARAGE: SHORELINE: CONST TYPE: DECK: SETBACK: BANK HEIGHT: SEWAGE DISPOSAL: CON WATER SYSTEM: PUD BEDROOMS: BATHROOMS: Exist: Exist: Prop: Prop: Total: Total: Routing Date: , / 15 10 Co 0.- .7) Type Amount Paid By: Date: Receipt: A Approved/Date Permit $50.50 KAS 06/12/06 83445 State Building Code $4.50 KAS 06/12/06 83445 JUL r„ 2006 Total: $55.00 Jefferson County Planning &Building Department CAUse rTh ?5-p--)&tcr-- • DEMOLITION PERMIT Jefferson County Department of Community Development 621 Sheridan Street, Port Townsend, WA 98368 (360)379-4450 FAX (360)379-4451 PERMIT #: BLD06-00332 Received Date 6/12/2006 SITE ADDRESS: 114 MAPLE AVE Issue Date 7/6/2006 BRINNON, 98320 APPLICANT: WILLIAM L OSKAM PHONE: (360) 796-0162 MAYE DONNA OSKAM 114 MAPLE AVE BRINNON WA 98320-9602 4 SUBDIVISION: DUPUIS SHORT PLAT Block: Lot: PARCEL NUMBER: 502313049 Section: 31 Township: 25N Range: 02W CONTRACTOR: OWNER/BUILDER PHONE: OWNER, WILLIAM L OSKAM PHONE: (360) 796-0162 if different: MAYE DONNA OSKAM 114 MAPLE AVE BRINNON WA 98320-9602 PROJECT DESCRIPTION: DEMOLISH EXISTING MANUFACTURED HOME THIS PERMIT IS VALID FOR ONE YEAR AND IS NOT RENEWABLE. THE FINAL INSPECTION MUST BE SCHEDULED AND PASSED WITHIN THAT YEAR. THE EXPIRATION DATE IS 7/6/2007. REQUIRED INSPECTION: FinalApproval: LLt'a ,h`I 1" I�� -7- (7-07 - BUILDING INSPECTION HOT-LINE 379-4455. CALL 24 HOURS IN ADVANCE TO SCHEDULE INSPECTIONS. Office Hours 9:00 a.m. -4:30 p.m. SPECIAL CONDITIONS APPLY - SEE REVERSE HOT LINE AVAILABLE 24 HOURS A DAY 7 • • SPECIAL CONDITIONS FOR CASE#BLD06-00332: 1.) The application was reviewed by the Jefferson County Department of Community Development staff on June 15, 2006 for the potential presence of Environmentally Sensitive Areas (ESAs) under the provisions of the Unified Development Code (UDC). After an initial Geographic Information Systems mapping review and an investigative site inspection, the following ESAs were confirmed to be present on the subject property: spotted owl; landslide 1; SARPA aquifer recharge area. 2.) Aquifer Recharge Areas in Jefferson County are characterized by porous geological formations that allow percolation of the surface water into the soils and the underlying zone of saturation. Aquifers are geologic formations that contain sufficient saturated permeable material to yield significant quantities of water to wells and springs. Aquifers serve as the source of drinking water within most of the rural portions of Jefferson County. 3.) Susceptible Aquifer Recharge Areas are those with geologic and hydrologic conditions that promote rapid infiltration of recharge waters to groundwater aquifers. 4.) Critical Aquifer Recharge Areas are defined as Seawater Intrusion Areas, and Special Aquifer Recharge Protection Areas and the following land uses located within Susceptible Aquifer Recharge Areas (1)All Industrial Land Uses (2)All Commercial Uses (3)All Rural Residential Land Uses requiring a Discretionary Use or Conditional Use Permit (4)All Rural Residential Land Uses with nonconforming uses that would otherwise require a Discretionary Use or Conditional Use Permit(5) Unsewered Planned Rural Residential Developments (6) Unsewered residential development with gross densities greater than one unit per acre. All of the above listed uses shall be subject to the applicable requirements and standards of the Jefferson County Unified Development Code. 5.) Geologically Hazardous Areas in Jefferson County are characterized by slope, soil type, geologic material, and groundwater that may combine to create problems with slope stability, erosion, and water quality during and after construction or during natural events such as earthquakes or severe rainstorms. 6.) Jefferson County has determined that the use of real property for agriculture and forestry operations is a high priority and favored use in the county. The county will not consider to be a nuisance those inconveniences or discomforts arising from such operations, if such operations are consistent with commonly accepted best management practices in compliance with local, state, and federal laws. If your real property includes or is within five hundred (500) feet of real property designated as Rural Residential 1:10 or 1:20, Rural Industrial, Rural Commercial, Agriculture, or Forestry, you may be subject to inconveniences or discomforts arising from such farming and forestry operations, including but not limited to noise, tree removal, odors, flies, fumes, dust, smoke, the operation of farm and forestry machinery during any 24-hour period, the storage and disposal or manure, and the application of permitted fertilizers and permitted pesticides. One or more of these inconveniences may occur as a result of agricultural and forestry operations which are in conformance with existing laws and regulations. 7.) A vegetative buffer of 30-feet shall be permanently maintained from the top or edge of the Landslide Hazard Area. All buffers shall be measured perpendicularly from the top of the Landslide Hazard Area. 8.) Landslide Hazard Areas and their associated buffers shall remain naturally vegetated. Should buffer disturbance occur during construction, the Unified Development Code (UDC)Administrator shall require replanting with native vegetation. No alterations shall be made to the Landslide Hazard Area or its associated buffer without prior authorization by the UDC Administrator. 9.) Prior to and during approved construction activities, the perimeter of the landslide hazard area buffer shall be marked with a temporary sign. The sign shall be placed in such a manner that it can be directly observed from the construction area. The sign shall contain the following statement: "Landslide Hazard Area and Buffer- Do not Remove or Alter Existing Vegetation." 10.) All construction activities shall not encroach upon the landslide hazard area buffer. This includes the storage or preparation of materials. 11.) The applicant shall permanently separate the boundary of the Landslide Hazard Area Buffer from the remainder of the subject property through installing logs, trees, a hedge row, or any other prominent physical marking approved by the UDC Administrator. • • 12.) Critical Aquifer Recharge Areas may require special protection measures to mitigate water quality degradation. The submitted proposal does not require additional aquifer protection measures. However, during construction the project shall follow the Best Management Practices (BMPs) and facility design standards as identified and defined in the Stormwater Management Manual for the Puget Sound Basin. 13.) The applicant is not proposing any land disturbing activities or proposing to create impervious surface as the permit is to demolish an existing manufacture home. 14.) The project shall adhere to the Best Management Practices (BMPs)to control stormwater, erosion and sediment during construction. BMPs shall address permanent measures to stabilize soil exposed during construction, and in the design and operation of stormwater and drainage control systems. 15.) Jefferson County determined that this proposal is categorically exempt from review under the State Environmental Policy Act (SEPA) pursuant to WAC 197-11-800(1)(b)(i). 16.) The site plan as submitted with the building permit application on June 12, 2006 has been reviewed for consistency under the UDC, and has been approved by Jefferson County Department of Community Development. Any modifications, changes, and/or additions to the stamped, approved site plan dated June 15, 2006 shall be resubmitted for review and approval by Jefferson County Department of Community Development. 17.) This approval is to demolish a manufactured home only. Any future permits on this site are subject to review for consistency with applicable codes and ordinances and does not preclude review and conditions which may be placed on future permits. 18.) Outdoor residential storage shall be maintained in an orderly manner and shall create no fire, safety, health or sanitary hazard. 19.) Not more than two (2) unlicensed or inoperable vehicles shall be stored on any lot less than one-half acre unless totally screened from view of neighboring dwellings and rights-of-way. Such screening shall meet all applicable performance and development standards specific to the district in which the storage is kept, and shall be in keeping with the character of the area. Screening shall meet the requirements of Unified Development Code (UDC) Section 6. Outdoor storage of thirteen (13) or more unlicensed or inoperable vehicles is prohibited except in those districts where specified as an automobile wrecking yard or junk (or salvage) yard and allowed as a Permitted Use in Table 3-1 of the UDC, and such storage shall meet the requirements of UDC Section 4.10. In no case, shall any such unlicensed or inoperable vehiclesbe stored in an Environmentally Sensitive Area (ESA). 20.) Maximum lot coverage is not to exceed 25%. Lot coverage is defined as amount of impervious surface which includes roof tops, driveways, concrete, etc. 21.) Minimum setback from Maple Avenue and any private ingress/egress easement right-of-ways shall be 20 feet. Minimum side and rear yard setbacks shall be 5 feet. 22.) Exterior lighting for residential uses shall not exceed twenty feet(20') in height from the finished grade, excepting when such lighting is an integral part of a building or structure. Ground level lighting is encouraged. 23.) Lighting fixtures shall be designed and hooded to prevent the light source from being directly visible from outside the boundaries of the property. The intensity or brightness of all lighting, during construction and after project completion shall not adversely affect the use of surrounding properties or adjoining rights-of-way. 24.) The building height is not to exceed 35 feet. 25.) An address of 114 Maple Avenue, Brinnon has been assigned to the parcel. Maple Avenue is a county local access (C201909). 26.) The lot was created through the Dupuis Short Plat on November 21, 1988 under AFN 318322. 27.) A septic permit (SEP88-0224)was approved on October 18, 1988 but not finaled. An EES has been reviewed by Environmental Health on July 4, 2006. A building permit (BLD92-0471)for a mobile home installation was cancelled on July 27, 1992. A building permit (BLD06-0270)for a manufactured home installation will be issued at the same time. 28.) The lot is served by an existing PUD water connection. 29.) The parcel has been designated as RR 1:5 under the Jefferson County Comprhensive Land Use Map effective August 28, 1998. I:\F_BLD_Permit_Propane.rpt 10/29/19c ��Ialy cr ; v-- lit f 1 • . r f 1 • •� RCAA ARERSON COUNTY DCO Notification of Demolition Permit It is unlawful for any person to cause or allow the demolition (or major renovation) of any structure unless all asbestos- containing materials have been removed from the area to be demolished. Work shall not commence on an asbestos project or demolition unless the owner or operator has obtained written approval from ORC.AA. A written application for a demolition shall include a certification that there is no known asbestos-containing material remaining in the area of the structure. Project ite Address: //y M p/F I) ( t. County: City: I A) A/r Al State: L c/F_SA r Zip: 'J�Z Starting `)ate: &E,/ ,2 t/! C Completion Date: i 4 J *(There is a 10 working day advance notification period from receipt of permit application) ); J(; /3 r5KAN Property Owner: Met ye- .c)A_)t) C5/k/9l`/ Telephone: 3GC - Xi/ C'/ 6-•>) Fax: Mailing Address: //q /))/9p/t= v U L City: ti C' State: (A;' A5A. Zip: Demolition Contractor: Pe0pt.>) ) / ("1 L, ,k -a State License #: Mailing Address: //e/ /'Jdtp/E r/ t% F" City: 3 1 , iu 1)p�; State: i 1, I 5 f). Zip: _1 Contact Person: may( i r,,t y C s 6 iv Telephone: 3t L • /ci e7/h ;Z Fax: YES NO 9.2563t 1.3E kG Demolition by Wrecking or Dismantling? ($25.00 fee) check # Training Fire Demolition? (If yes, attach fire department request for training fire) ' J enovation, Alteration, Remodeling, Maintenance, or other Construction? Asbestos found or suspected* *An ORCAA "Notice of Intent to Remove or Encapsulate Asbestos"form and appropriate fee must be submitted pnor to any asbestos removal work. Asbestos removal projects involving demolition must be preformed by a Certified Asbestos Contractor and all friable or potentially friable asbestos must be removed before any demolition begins. Refer to ORCAA Regulation 1 Article 14 for additional requirements that may apply. Asbestos Survey Completed by AHERA Certified Inspector ��`� �`../.A.4-2 `.4LY` Certification # (-01/ 1"I1 4 - co v.i 2-O4- 14 This approved permit must Enclose$25 Certification of the Asbestos Survey must be available at the job site Processing Fee accompany this foim 2940 B Limited Lane NW,Olympia, Washington 98_502 360-586-1044 * 800-422-5673 * fax 360-491-6308 homepage: www.orcaa.org * email: info a orcaa.or, key ," 'i (l Date: Initial Date Application Received Amended: ❑_ " �,•*v``tt `"',.ky 2940 B Limited Lane NW ck; Olympia, WA 98502 Completion: ❑ ,-�:,,., Phone: (360) 586-1044 ORCAA i Fax: (360) 491-6308 Annual: U S500 www.ORCAA org 1 Permit Application for an Asbestos Project A Pr[ect Type._ 10 Asbestos Reim,\,ii , 2. 0 Rcno ati,oi 3. 0 Ntaintenancc 4 Encapsulation 5. Demolition 6. ❑ Emergency 7. Other: p 1 ID B. Property Owner: LU t ILA N 1- Mrwe bo o a 05 K am- Phone_c? 796_- 0/6 a Property Owner's M n T Mailing Address: litii A_pie-- Five City:E iftWO�_-I State: (,v� . I Zip' 3-1[) C. Asbestos Contractor: Contractor Owner/CEO: , AbOl te5t__10.5he6 taS _ _CAO•SLAL 4a.At ' ,-- SQL Wi+heL,dy '. I Mailing Address_40l) �e. d f,- ,5 -- Phone: 134_0j 385 e 1 1 er City: "+ Tpujil3 se .tie State_ ',.. _ _Zip_ 3i6 Fax: ( ) D. Site Address: I _- 11`�l- --M Aple A u i City:821.PALo . state_ f, ! jip 8i3,'1) Project Manager or _Contact Person: M � intJAIA 06 — Phone_1. �) 7�� Q f{j, E. sbestos Sure ey' r No.of Structures: Date Asbestos Survey Conducted: Was Asbestos Found? 1 ❑ Mat'l Presumed: ❑Yes -- t ; 5--Q95- 0(0 Iiiii If No,Attach Surve\ AHERA Building 4V AHFR4sr.Rrfr f5RFP/1R/7,5 1)RF,r.!1,1-an11110 Certification No.: Expiration Date: Inspector Name: P/n2n,I.. y)R M o ' -oo`' d o6-- sob (A1+h e etd e_ AO-i - 06 �tQlB y i F. Demolition No.of Structures: I Start CI Training Fire(List Fire Dept.as demolition contractor below Information: DateO6Jav/ D ❑ Ordered Demolition)attach copy of Order) 1 / b Demolition r ,,�.,m.r._, m.,,,�,.:.u•,„ r �....�, ,, ,, . Contractor: Phone:3(� 1 0 i 6 hj2tnp�e� nW ee 7gt6 G. Asbestos No.of Structures:(see ! Start Date: , Completion Wk. Days: M 1 W' Th I- Sa Su Project back if I 1 AY '"/'7 I Date j4 Hours: I ,//) Information: �(J , I Will all asbestos material he remo ed h, . N Total Quantity to be Removed: Square l ect Linear Feet project completion'?❑ Yes Li No AVA, Thermal Thermal System Insulation: Hoiler/furnace Ins y -❑Duct Ins. � Pipe In. I ()uber Nig . Surfacing Mat'I-i+❑Fireprootiint I�Paints I, Plaster 1 ZI at Textured('oines (Ubs r Misc.Marl': I Cement Rd. i ❑Cement Pipe i tiptoe r rr `.1a 1 I ❑Rrx,ftn- s 1.t•1 I ,rb:_r H. Asbestos/Demolition Project Categories: r No_ti_tication Waiting, NONRFFI ND,+B F: i _FEF_ I. -❑Residential Dwelling Asbestos Removal Project NA Prior Notice i T S25 2. demolition 10 Working Days_ S25 3. Chess than 10 linear feet or less than 1 1 square feet /O Prior Notice , S25 4. 10-259 linear feet or 1 1 - 159 Syuare feet AO II) W oil.ut_ I)is S I ht1 5._0260 999linear feet or 160 4.999 square feet *A ; It) \\'irking Days S250 6. 01,000 9,999 linear feet or 5.000-49,999 square feet 44; 10 Working I)ays $StIt C _ , . 7. ❑10 000+ linear feet or 50,000, square feet 10 V orking Day, SI.1I!1) y /� _8. ❑Annual Permit tLrmitt:d removal,additional permits,contact O �,�t� Prior to start of New Year SSrtrr 9.-0Ernergency Project itlo Prior Notice S;u 10.ITAmendmentstio fee for I 'and 2' amendment) 4 Prior Notice ti'5 I. I do hereby certify that the information contained in this notification.and supplemental dat.r Pasmeni receised date: described herein,is to the tract oC no Ano«ledge accurate and complete I I r shall not cause or allo RResiened es iewed hate: 4 i j 4 J +% 1![., y 1 t am asbestos protect or demolition activities to begin until the a ro rate ssaitin nod has ,j ( \ Ill ( , elapsed i Permit Number: 'A4 ,�/: 0 r 9/ Date faxed mailed notification to applicant Sr nature- /t g / \_ _. __ ��- p�tNUate C/ �/ For Compliance with Regutal t 1.Sitcllun 14-I stos 1 ""/ OIJ ` SO/ P _ t ene l'SE�Only Print Name tM ��} eprescnhng CC.��� (/ _ R' Res .17,o70a O kk' JEffEOSiN COUNTY OH • gSON co� JEFFEFON COUNT: �. W `lg ,.} DEPARTMENT OF COMMUNITY DEVELOPMENT 13 _Ai 621 Sheridan Street • Port Townsend • Washington 98368 360/379-4450 • 360/379-4451 Fax J l A 2006 q�, Np�p' www.co.jefferson.wa.us/commdeveloprhient F . 'n ► 1'1!1Arr Master Permit Application MLA: LK. Project Description (include separate sheets as necessary): �) ,hu ci (Vic f (Lt Property Tax Parcel Number: ,:J 3L ? l v r Size: ) , ? ;a S (acres/square feet) Site Address and/or Directions to Property: /,'t/ ,f/q J e- ./ Property Owner(s)of Record: ;',�j l,/,r„ •�(�'k, jt A Cc.ka ivy Telephone: (; `7C) f-)(g),._ Fax: email: Mailing Address: I2K IiYl9 l e A IqZtl.)Aic j.) Applicant/Agent(if different from owner): Telephone: Fax: email: Mailing Address: What kind of Permit? (Check each box that applies) ❑ Building ❑Variance(Minor, Major or Reasonable Economic Use) A Demolition Permit ❑ Conditional Use[C(a), C(d),or C]** 0 Single Family ❑ Discretionary"D"or Unnamed Use Classification ❑ Garage Attached/Detached ❑ Special Use(Essential Public Facilities)** ce Manufactured Home ❑ Boundary Line Adjustment ❑ Modular ❑ Short Plat** ❑ Commercial* ❑ Binding Site Plan** ❑ Change of Use ❑ Long Plat** ❑Address ❑ Road Approach ❑ Planned Rural Residential Development(PRRD)/Amendments** ❑ Propane ❑ Plat Vacation/Alteration** ❑Allowed"Yes" Use Consistency Analysis ❑ Shoreline Master Program Exemption/Permit Revisions** ❑ Stormwater Management ❑ Shoreline Management Substantial Development** ❑ Site Plan Approval Advance Determination(SPAAD)* Li Shoreline Management Variance ❑ Temporary Use ❑ Comprehensive Plan/UDC/Land Use District Map Amendment ❑Wireless Telecommunication* ❑Jefferson County Shoreline Master Program Amendment ❑ Forest Practices Act/Release of Six-Year Moratorium *May require a Pre—Application Conference **Requires a Pre-Application Conference Please identify any other local, state or federal permits required for this proposal, if known: DESIGNATION OF AGENT I hereby designate to act as my agent in matters relating to this application for permit(s). OWNER SIGNATURE _ Date: By signing this application form,the owner/agent attests that the information provided herein,and in any attachments, is true and correct to the best of his,her or it's knowledge. Any material falsehood or any omission of a material fact made by the owner/agent with respect to this application packet may result in this permit being null and void. I further agree to save, indemnify and hold harmless Jefferson County against all liabilities,judgments,court costs, reasonable attorney's fees and expenses which may in any way accrue against Jefferson County as a result of or in consequence of the granting of this permit. I further agree to provide access and right of entry to Jefferson County and its employees, representatives or agents for the sole purpose of application review and any required later inspections.Access and right of entry to this property shall be requested and shall occur only during regular business hours. /, J J/, Signature: L'V,(A 1.1 d-C". Date: Y114y ?tn c C. 6. The action or actions Applicant will undertake as a result of the issuance of this permit may negatively impact upon one or more threatened or endangered species and could lead to a potential"take"of an endangered species as those terms are defined in the federal law known as the "Endangered Species Act"or"ESA."Jefferson County makes no assurances to the applicant that the actions that will be undertaken because this permit has been issued will not violate the ESA. Any individual,group or agency can file a lawsuit on behalf of an endangered species regarding your action(s) even if you are in compliance with the Jefferson County development code.The Applicant acknowledges that he,she or it holds individual and non- transferable respoon//s�ibility f( adhef in to and complying with the ESA. The Applicant has read this disclaimer and signs and dates it below. Signature: ,t14,,ICC.M �C [�!,.s„1 Date: „Tv rJE g ? C.F� G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc BUILDER STATEMENT• The signer of this statement does hereby certify that they are the Owners of the parcel referenced herein,that they are not licensed contractors and that they will be assuming the responsibility of the General Contractor for the proposed project. Signature: C(.�Lat ��, (>„).4',v . Date: :)ritW'r% ',, "L oat GENERAL CONTRACTOR OR MANUFACTURED HOME INSTALLER: PHONE: FAX: ( ) ( ) MAILING ADDRESS: EMAIL: CONTRACTOR'S LICENSE WAINS NUMBER: NUMBER ARCHITECT/ENGINEER: PHONE ( ) FAX: ( ) MAILING ADDRESS: EMAIL Project Type: Frame Type: Bathrooms: Shoreline: Type of Sewage Disposal: 0 New ❑ Wood Existing: I Li Sewer [I Addition 0 Steel Proposed: <- Bank Height: ❑ Community System I I Alteration/Remodel ' 11 Concrete Total: „ F] Individual System I Repair Li Masonry SEP Permit#>tf ay'-CZ'It4 Demolition [1 Other: Bedrooms: Water Supply: Existing: f Setback: ❑ Private well 0 Two Party Type of Heat: Proposed: C K.Public J` I,- Total: <-. Name of System: -jr f (.; t.,..: I) 14 I. If this is a Commercial Project you must answer the following: Number of Parking Spaces: Current: Proposed: Number of ADA Parking Spaces: Number of occupants(includes owners,tenants,employees,etc) Current Proposed IBC Occupancy: IBC Type of construction: Will you have Food Service? Yes / No If this is a Propane Tank and/or Appliance Installation permit,mark all items below that apply: i I Underground Tank [I Above ground Tank Size of Propane Tank: [i Heat Stove ❑ Cook Stove I 1 Woodstove L1 Fireplace Insert ❑ Hot Water Tank I I Pellet Stove Ll Other Is this appliance being installed in a Manufactured/Mobile Home? Yes / No When applying for a permit to install a propane tank you must also submit a site plan showing all of the buildings,all property lines, tank location and size, distances from the propane tank to all property lines, buildings and septic system components, including the reserve area. Square Footage Current Proposed For Office Use Only Amount Revision Main Floor Heated EH Bld App Review: b5.or) 2n°Floor Heated Consistency Review: 15.cc Other Heated Base fee: r�r, Mezzanine tr Additional Section: Heated Basement Plan Check fee: t Unheated Basement State Surcharge fee: JE�fE�S, 4.5c: Other Unheated l ! =U . Pot Water Review fee: _ Garage/Carport SUBTOTAL t c IL) CC, Decks 911/Rd Approach fee: � 151- ink Other TOTAL: $ ''l3 CC' Receipt Number: 0?)4[ 5 Cash/Check Number: b � ESTIMATED COST(REQUIRED) Date:.Fair market value of all labor and materials foundation to finish [Li (AICX Initials: G:\PermitCenter\FORMS\DRD FORMS\Master Permit Application 12-30-05.doc G '0 V\ o r.m 3 n -'`� i — m i—L-. * _ .__ _._._. - - _ .. .._ em . 1 I i = ,O;----"E‘ - , c C v r- • i 1 V C A -�1 q 7C 4 Y •-. t.) n •--•-_. ._-i-__ --=.----C''!---.pp 1-` c., • r 'RN ' v .....o PRoD it►r.dL 39/ ' h my. W ti a n ,O v • z °, � � `"N,, <� covs t i __--. . \,. 1 <i r 46 Q COa - ._ _n� aMI s It fi �s, `\ VI rsir'rk; '\\'''z'''',/,‘.../-/-* 1 . 0 •if -4, ' 4:. 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