HomeMy WebLinkAboutBLD1999-00681 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:
9 Digit Parcel Identification Number (from your tax statement) 3 B ?0 ( a 3
03_5-
Site Address:
91 1# & Road Name ,
it. f r 4 • EPTz- Zip Code
Legal Description:
Subdivision Name CA Cl=o6c 1z
1, / fr Block /0 Lot(s) 3 S,g
Section Township 3 u North, Range 0 i2t) WM
Parcel Size (acres or square footage) 7
Property Owner K/$ l/ /JI A ev C
/14 Phone 36 O 3', -42 OG
Mailing Address
Applicant/Occupant 9'33 6
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(if different)
� Phone
Mailing Address
Authorized Rep
Mailing Address
Phone
General Contractor
���J2 Phone
Manufactured Home Installer
Mailing Address
Phone
Contractor's State License Number
Expiration Date
Septic Designer tC) Li t re- A S
Mailing Address
Phone38$-3�
Mailing Address 2 r-#.E��.e./e--rs 4,: PT.
zo4-c) .E 6 6�
Loan Lender/General
Contractor's Bond Holder Phone
Mailing Address
FOR OFFICE USE ONLY
Fire District to Planning District School District