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Project Description:
New Single Family Residence W/Attached Garage
9 Digit Parcel Identification Number(from your tax statement):
998-700-088 -
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MIN
Site Address
911#: Road Name: Clear View Place Zip Code: 98365
—
Legal Description
Subdivision Name: Teal Lake Village Block: Lot(s): 88
Section: 21 & 16 Township: 28 Range: lE
Parcel Size (acres or square footage):
Property Owner. Olympic Real Estate Dev. LLC Phone: (360) 437-2101
Mailing Address: 781 Walker Way, Port Ludlow, WA 98365
•
t Applicant/Occupant: • Same Phone:
(if different from owner) —
Mailing Address:
Authorized Rep: Jeff Evanger Phone: (360) 437-2101
Mailing Address:
781 Walker Way, Port Ludlow, WA 98365
General Contractor.
Or Manufactured Home Installer. Olympic Real Estate Dev LLC Phone: (360) 437-2101
Mailing Address:
781 Walker Way, Port Ludlow, WA 98365
Contractor's State License Number. OLYMPREO1OM8 [ Expiration Date: 6/01/00
Septic Designer. Phone:
_
Mailing Address:
I _
Architect:/Engineer: Phone:
Mailing Address:
Loan Lender/General Phone:
Parker, Smith & Feek 1-800-457-0220
Contractor's Bond Holder: —
Mailing Address:
FOR OFFICE USE ONLY' .
Fire District: Planning Area: :.: :'.` School District Zone:
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