HomeMy WebLinkAboutBLD1996-00352 Jefferson County Permit Center, 621 Sheridan St, Port Townsend WA 98368
• UNIVERSAL PLOT PLAN
Fill in the following information as completely as possible.
Project Description: addlik%oel x�13��: '
9 Digit Parcel Identification Number if your tax statement) 919A2 �e)a /Q
Site Address:
911# & Road Name 1( `t\�caoc`n° C* 66 r-' 1 Zip Code
Legal Description:
Subdivision Name 7/�'i /7-ON Co E5Z-Si MS" ,4J1iv; Block / / Lot(s) C
Section 4/ Township „„Zj North,Range.,2 k/ WM
Parcel Size (acres or square footage) ,..70/ oC 45—y
Property Owner p/P.Fj( / ieri [j/2PiAve- Phone 34,,,,Z1--79/".Y,479
Mailing Address /'/ Ii4'/l/'fs1 nP 5 CC ,?aE'//vN0At, li/A 7
Applicant/Occupant /7RE- ,!=L E �C!/?.pjAl Phone 36,p—7`j a 7�
(if different)
Mailing Address 5/$01F
Authorized Rep Phone
Mailing Address
General Contractor t� q �,� Phone
Mailing Address
Contractor's State License Number Expiration Date
Septic Designer /9/ck /r: h/7/if) c? Phone
Mailing Address
Architect Phone
Mailing Address
Loan Lender/General Phone
Contractor's Bond Holder
Mailing Address
FOR OFFICE USE ONLY
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Fire District ( Planning District it School District Zone
Case Number