HomeMy WebLinkAboutBLD1999-00129 co Jefferson County Permit Carter ' Department of Community Development
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�;, 621 Sheridan Street,Port Townseril WA 08368(3601370-4450
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Project Description:
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9 Digit Parcel Identification Number(from your tax statement): C.9.e../.0 c,"‘,_, rs,5,,
Site Address . +
911#: �, Road Name: /c/Q/1' 4 Zip Code: 7 FK".8.
Legal Description p-�
Subdivision Name: l � d�/.4. V1c/c 4/ Block: Lot(s):
Section: ownship: Range:
Parcel Size (acres or square footage): 4, , o V Are 2- c,.o
propertyPhone:
Mailing Address: 5 E
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Applicant/Occupant: Phone:
(if different from owner) „n e_. , r V v tea=
Mailing Address:
Authorized Rep: Phone:
Mailing Address:
General Contractor:
Or Manufactured Home Installer: y' ~x 0/7 Phone:
Mailing Address:
Contractor's State License Number: Expiration Date:
Septic Designer: c C"" >'lI Phone:
Mailing Address:
Architect:/Engineer: Phone:
Mailing Address:
Loan Lender/General Phone:
Contractor's Bond Holder: CI—E a k
tAdMailing Address:
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