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HomeMy WebLinkAboutBLD2023-01050 - BLD CD Environmental Health Review - 9/12/2023 4pMASON COUNTY Permit No:-914 926t3 a 61656 COMMUNITY DEVELOPMENT RECEI�'vEEU T PermRKeistance Qntae Bullainy Planning SEEN }OPNMENfAL BUILDING PERMIT APPLICATION JJJ TH PROPERTY OWNER INFORMATION: CONTRACTOR INFORMA . If NAME:JO E 1 NAME: U.ITELb&Tt�7 ICO //N MAII,ING ADDRESS: l MAII.WG ADDRESS: CITY: STATE: ZU. CRY: l"ISTATE04A, ZIP: PHODMI01 - — PHONE: CELL' O(a I PH0NE#2: 1 - 4 EMAIL tj �TW,1GT"10t�• EMAIL. tx2. L&.I REG q 1 XP._/ /_ cc)" RIA4Y CO ACT: W R CO MANTRACTOR❑ OTHER r 4�1 NAME EIL MAIWNGADORESE CITY STATE_ZIP PHONE CELL N PARCEL INFORMATION: 1 �E PARCELM ER(12D,,tNuMbdr)52,30C - .rlO- Q00�3 ZONING :R:EC1EI ZOLEGAL DESCRIPTION(Abbsehatal FIRE DISTRICTVED X SITE ADDRESS CRY DUUCITONS TO SITE ADDRESS �.I GG ISIHEPRWECTWITHW30DFIOFSLOPE(S)GREATERT 14%: YES[] NO Iy SNOWLOAD:�Pst ISPROPERTYWITH1312WITOFTREFOLLOWING: (Ck dyhagral SALTWATER❑ LAKE❑ RIVER/CREEK❑ POND❑ WETLAND❑ SEASONALRUNOFF❑ STREAM❑ TYPE OF WORK: NE'Wg ADDITION❑ ALTERATION❑ REPAIR❑ OTHER USEOFSTRUCTURE(RerU mina•.cm.,anlF ,v) ISUSE: PRIMARY❑ SEASONALjr NUMBEROFBEDRCOMS 1,1104BER OF BATHROOMS_. HEATEDSTRUCTURE} YESIF. AdE,I❑ YESTrmnT•)d,`BW❑ NO0 DFSCRRiE WORK O1ARE�GL(w.m+•9 2�/ho IST FLOORU00 sq.ft ZND FLOORA"K.R. 3RD FLOOR sq.ft BASEMENT M.ft DECK sq.R COVEREDDECK eq.ft STORAGE q.0. OTHER sq.It GARAGE sq.R. AaachedD Detached❑ CARPORT p.ft. AiMchedD DefachedD MANUFACT •G COPIES OF THE FLOOR PLAN REQUIRED- MODEL LEN TH BEDROOMS BATHS SERW,NUN[BER ENVIRONMENTAL HEALTH: SEWAGFISEWER SOURCE: SEPTIC,A SEWER❑ / NEW❑ EXISTINGA PLUMBMGINSTRUCTURE? Yjg NOS Tf,,,attxh cumpTes.d Winer Ad,q d,Form PERIMETERTOUNDATION//DRAINS PROPOSED? YME] NQW EXISTINGS(I.PT. EXISTING BEDROOMS_y��_ PROPOSEDBEDROOMS_A_ TOTALBEDROOME_I— mvrde bady,I comer and thorror Madam da min rerun in.aw innname ano ndWdo .sarmas ealmeaa surn�.M droned•Heim.,. eeaer,that heeawm.r.na,mnmraewretnet nd older om,emi of roan radneuao&pried..nmommaronew homelads,reion .reter,anmem,maa n an mend Is seenvesemem holder or ..1ures of roman reyem odm1no om. mewan mlenel reoreeem.aw.re r mom to d me rdshonnm prmNem isohmneme and Gino:emNmwea m Mason LwnN common me snow eeseneee property, anys,4. roran-r aa'inana ties.era Ueda 1q'�mtun moose nonawia nxwn or aummmea umnawtimn'is nmmmmemm smintin am mrnmmswmmn.an¢sm�eneea m e P.aua a tam awa. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF IN DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.IM/sSON COUNTY LOGE 10.OEA1) X� ,�t P 4-5 — a Syruwro MOWNER(Hurt Ee nlenetlMMe OWNERINER) Code DEPARTMENTALREVIEW APPROVED DATE DENIED DATE TAGS/NOTFHrCONDRIONS BUILDING DEPARTMENT PLANNING DEPARTMENT FIRE MARSHAL PUBMCHEALTN tI K __ a#g Ea$ ,- cni oy�� � k 3e4 A __ alb $ , 8400 v Z a - --a -' _ 3 $ D m ' Z m T N � 10 m N y ----------------- ------ ____ ____________ - m ___ ---________ _ _ _ ___ 10 -,-- c _______ ___ ____________________ dl A' OZ----------------- I --------- o - c - - o oGG x o AF ©----- '--.1 - I