HomeMy WebLinkAboutBLD1987-00447 IP N E • RO O FEET
I. LOCATION: yrographic name S W SIDE OF
N E -"" ROAD AND t 2 In ,s, l p�J '� I ROAD
S W FROM INTERSECTION OF 4
other specific location or landmark:,
LEGAL DESCRIPTION: Block Si�"s�°� y j
r Lot vl�j�t/ / C+..i
"' Y.Section Section Township Range
Tax Number
II.TYPE AND COST OF BUILDING -
BUILDING TYPE MOBILITY
•
TYPE OF IMPROVEMENT CD New County Resident
0 Single Family
❑New building Is this structure to serve the residential
lt
number 0 MuuFamily
number of units 0 or commercial needs of those employed
Alteration Hotel,Motel, Dormitory at either the US.Navy's Trident or
Repair,replacement number of units__------ Indian Island Facilities?
0 Wrecking 0 Mobile Home
0 Moving(relocation)
Other—Specify ❑YES ONO
0 Foundation only
v`
USE
OWNERSHIP 0 Full-time Residence
Privateonpr (individual,corporation,,et - ❑Second Home:Recreation Cabin,etc.
Ononprofit institution,etc.) / ❑Second Home:Future conversion to
' 0 Public(Federal,State or local gov't.) UBC OCCUPANCY GBOUP: L permanent residence('� (Omit cents) Nonresidential— Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement $ processing plant,machine shop,
' . COST laundry building at hospital,elementary
To be installed but not included school,secondary school,college,parochial school,parking garage for
department store,rental office building,office building at industrial plant.
in the above cost If use of existing building is being changed,enter proposed use.
a. Electrical
b. I C /'� I
C( j�( 4 . / 6
Plumbing
c. Heating,air conditioning
d. Other(elevator,etc.)
• TOTAL COST OF IMPROVEMENT S
t ^III.SELECTED CHARACTERISTICS OF BUILDING -
DIMENSIONS
PRINCIPAL TYPE OF FRAME
0 Masonry(wall bearing) TYPE OF SEWAGE DISPOSAL •Number of Stories
9 L. Public or Private •Total square feet of floor area,
i ❑Individual (septic tank,etc.) all floors,based on exterior
Fi �f Wood Frame dimensions
structural steel
Struc
TYPE OF WATER SUPPLY •Total land area,sq.ft.
i0 Reinforced concrete Public or private company
i NUMBER OF OFF-STREET
. • Other—Specify 0 Individual (well,cistern) PARKING SPACES
Enclosed
I PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE EOutdoorsloses
t
' D011 RESIDENTIAL BUILDINGS ONLY ea-
Oil Number of bedrooms
❑Electricity TYPE OF MECHANICAL Full '
❑Coal • Number of
bathrooms Partial
❑Other—Specify
. .ck-- IV. IDENTIFICATION- ZIP code Tel.No.
' W Name � Mailing Address— Number,street,city and State � ���2/3715317
0 L-UOLObi
/1 Z. mtate Mu(7/� ,
-/ Contractor fri
3 I
Architect
The owner of this building and the undersigned agree to conform to all applicable laws.
our.
� q,
Signature Address 1 at
Applicat
2'(_)/g4lerr4, A6r-----of applicant, ;7'� �`� , a� c�/`' �. �'"t/ g/
FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
PLANNING AREA "
APPROVED BY t L �-',-- t r-
�. ,�n�•y I-(EAL H DEPARTMENT
APPROVED BY .^ ISSUE DATE RECEIPT NUMBER
PERMIT FEE
- --- // Sy' ,.:7?__15 0 _F7
BY: '''6�� 44 7,
072
C')R (1 ' ) 3S
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APPROVED
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