HomeMy WebLinkAboutBLD2024-00890 - BLD CD Environmental Health Review - 7/24/2024 MASON�COUNNN
COMMUNITY DEVELOPMENT RECEIVED
Permit Assistarme Center,Oullding,Planning JUL 23 2024
BUILDING PERMIT APPLICATION 615 W. Al er Street
r PROPERTY E r RNA I CONTRACTOR ITWORMATIONE
NAME' e' NAME' It fJ
MAME' A RES : / e GADDREss: IsTE
MAUKL _STATE: ZIP: CRY'
PHONE#1: PHO. PJ� S CELL - - �
PHONE#2; FM>ll
EMAH,
1 OWNRHQ CONTRACTOR t OTHER ^NA E O ,
Em
NAILING DD SS C CITY SLATE DP I/z
PIIONE ��'T� CELL O
r PARCEL INFORMATION:PARCELN. MBER(12 Digit%,mhtt) 32 A /C^ S3-06'0179^J
ZONING 1
LEGAL DESCRIPTION IAbN/cvieldl v FIRE DISTRICT' G
SITE ADDRGSs �// P(�f'`T / 0LL QL CITY (•�10
DIRECTI0NST0 ITEADDRESS L v
ISTHEPROACPWITMN MPTOPMOM(S)CRPATERT N 4%: YPSo N013 SNOWLOAD:--4 O
I LTIATERO LAKED Ff OF THEFOLD PUN : (nntm rnm.00r.): t r
� SALTWAISR� LAKE❑ RIYER/CRIiEK❑ PO?ID❑ WETLAND❑ SL'180NAL RUNO3F❑ SHtEAM❑
TYPE OF WORK: NEW❑ ADDITION❑ ALTERATION❑ REPAIRX OTHER
USE OFSTRUCIURHIAeaJmxeGvye,['e•�e+^1xi^Rhk.) C f i(A-9f/f P�
RUSE: PRIMARY SEASONAL❑ NUMBER OF BEDROOMS-„_NUMBER OF BATHROOMS
HEATEDSTRUCTURE? YRS(Wu [] YEEr INNtI❑ HOD
.,tee DESCRIBE WURR
I 'R'RI AQ T Mlpw�+l
I Sf FI.00R12 3au1.R 2ND FIAORN/4 q R. IRD FLOOR#&- .k nMF.ME.W_N.R
DECK N.R. CDVLRW DECK_N.H STORAGE N.R OTHER_N.R
G.IRAOE ! N.R .Umrked❑ Demrhed❑ CARroRTN.a Anwbd❑ pnerAml
MANUFAC rURED HOME INFORMATION: I-I4/COPIES OPTICS FLOOR PLAN REQUIRE"*
MAKE MODEL r�}{P�I�.YEAR/f 9..f LENGTH /
WIDTH 2 Q 1 BEDROOMS__ BATHE �Z SERIAL NUMBER
ENVIRONMENTAL HEALTH:
SEWAOESEWEASOURCE: SEPTIC SEWER / NEW❑ EXIS'IING�
PLUMBWG RI STRUCTURE? YESX NO❑ U.+*a•pain*ro Ple•'rI WaATA4*e Fom 1
PERIMETER/FOUNDATION DRAINS PROPOSED? YES❑ NO# ESISTING SQ.FT. i
IXISTMG BEDROOMS PROPOSEDBEDROOMS Z TOTAL BEDROOMS 2 1
GWNER ecknmukOPSlM1al sudniasion Winacwrera iMumetlpl meylearA lneshp xpk ntlpuFararll morafin.NFnwHetlgemeM of euCrMby r
sgnaWre beNw.l Declare NMlam lM1e ownx anE lfa�M1tt EetlasHlN lemanGtlM ro rvcenn Nb pamltaM ro CONe xroh es propmeE.IM1rva j
ubranatl permiulon M1om aI1 Ne naressary pelves IxluGng eM wsmae�e•c•L Tres of lMersY regmdLq N¢pmJeR Tlg miner or lead
represeNallve,repesenla Hr3 Na InbmwUon pmvtlatl'm rcmrtek ad Party enrWoyeec W Mesw CruMy aaeaz N1M1e a0wa J®enLW pCpRy
aM saupWrga)Im�irea eM inspeNwt TM1ia pemlNapplir'elun Oeven6 nW flvgtl Huwk ttaNMtlzeE cpnseuction¢nd cunmerceEwitlin 180 i
Eaya wHNMuclkn swAis syspentleC fineperlW dlBO tleys.
PROOF OF CONTINUATION OF WORN ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTNRY OP THIS
P IT APPLICATION OF 190 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE E%PIRFD.PiA"
C00NTY CODE 14.08AE)
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DEPARTMENTAL REVIEW APPROVED DATE DFNUD DATE TAGRINOTFS/CONDITIONS
BUB.DINGDEPARTMENT
PL WD*DEPARTMENT
FIRE MARSHAL
PUBLIC HEALTH �'
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