HomeMy WebLinkAboutBLD1996-00342 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: yJ(-2( (' . bL'( k.t t4i i/c4L.
9 Digit Parcel Identification Number (from your tax statement) 1 0 13 )3 0 0
Site Address: _
91 1# & Road Name 1 Q) I7 �u ( 1 D(�✓E Zip Code t ?)3
Legal Description:
Subdivision Name YY1,l Lfo6+vT LA--tnz CorijcSVV3vvc' Block Lot(s) L/
Section 3 7„ Township 1 North,Range I WM
Parcel Size (acres or square footage) c O,;1
Property Owner `+- U L./A- A f,fied-iij%S Phone (6e )
Mailing Address 0. is(DX (DO F-' C ol/,S k,C C3.C. UOU 4 R, O
Applicant/Occupant GUY v j s Phone 3 GCS
(if different)
Mailing Address b Lj t?c L1 fLi717, Cc T- PONT jOWWlS qlzidtol'7 6 aU(.
Authorized Rep Phone
Mailing Address
General Contractor ' G u v y�g_ `--- S d�I AL.,. Phone
Mailing Address d
Contractor's State License Number Expiration Date
Septic Designer - [• I- Phone
Mailing Address
Architect Aottpi2. Phone
Mailing Address
Loan Lender/General 06c/it/a-X., /''G/t4-2t4.44_ AV lJo 606; - 0410 C46 iii-1,7'y W. Phone I- 0 a -136%,6
Contractor's Bond Holder
Mailing Address /3 i//v L't , 67 uL.r()r i o/t 2 Cep.2,C-
FOR OFFICE USE ONLY
Fire District Planning District School District Zone
Case Number �� '�1 (47 °3�