HomeMy WebLinkAboutBLD1998-00578 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: NIN DLC ® 5r ' ,),e �lnh ,&.,r S'
9 Digit Parcel Identification Number (from your tax statement) Ej Z l I (p 3 O 0 mot
Site Address:
91 1# & Road Name L 4! r &r¢ GT. Zip Code 9 834,5—
Legal Description:
Subdivision Name l�A-y�t D E-- Block — Lot(s)
Section 1 to Township 2 8 kJ North, Range I tT WM
Parcel Size (acres or square footage) Y 5-0 Sir
Property Owner DA net hl
Phone
Mailing Address 11 (2.. Rp> o+<e ST; 4-4p)ceu i r.4-' CA- 9 Z‘7 p
Applicant/Occupant
Phone
(if different)
Mailing Address
Authorized Rep L,i-ob Cle1-roy-7-7 ASr ,u dv 17C�
1' rr77 sne Phone V3'7-2TO/
Mailing Address P CA 13pk 6s-917 , 7- Z- fr
36.S
General Contractor "NDeR, Cc s rarM 41syn/�� 467-e 5 Phone V32_2-5-0/
Manufactured Home Installer u /A"
Phone
Mailing Address P. 0. ,apt eo5 '/3 7 Polar L rt-
c'ay.3aS®
Contractor's State License Number
Expiration Date
Septic Designer JU/Pr
Phone
Mailing Address
Architect M rTthrA P .*-r-u'CACcS Phc24,6 (o2�-j3515!
Mailing Address q/41 Oih,E-10 y jGt- r — S00 Siier.T Ca 9r1 D /
Loan Lender/General tSre•,, ® �. '���
Lt‘s . Phone 16C) 2746-7 (t1
Contractor's Bond Holder
Mailing Address
FOR OFFICE USE ONL Y
Fire District Planning District School District
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