HomeMy WebLinkAboutBLD2024-01023 - BLD CD Environmental Health Review - 9/3/2024 C P..ftNRECEIV-W
MASON COUNTY
COMMUNITY DEVELOPMENT AUG 2 2 2024 z
P«mRAxhbme Gnhr.Buiwq wpT 615 W.Alder SYeei
BUILDING PERMIT APPLICATION — `�j m_ 77��V••[[��
PROPERTY O R CONTRACTOR INFORMATION• ,D Z
!r1Ri41 % NAME: m.
MAILING RES3 r MARLIN D S: I.
CI7y STATB —�ZW. CITY. ( TATE: ZIP: �lr
PHONE FI: ZCa730 for PHONE: ILL: Alf
PHONE 02: �lsLi $6�T nlO�/l� EMAIL: •'N D..
EMAIL: m _ 4Ns✓I„./ - L REG#
r
P YC NTA OWNER❑ CONTRACT OTHER❑
NAME SMALL F 0a1�L'IVICCa �G'BI
MAILIN REFS CITY V i LATE
PHONP 1'S 1 CBLL
PARCEL INFORMATION!
PARCELNUMBER(13DS, Nbmb«) 3ZJL7-57-"J12 ZONING CBS LOP
L P
/ �) / FMDI CT
S ADDRESCS�r'',,� I OF CITY 5iy- 11
DIRECTIONSTOSUBADDRESS �8`
MTHE,FROIEGTWFFRBJ3WnoF3LOPR(B)GR WRi N10%: ME] NON, MOW lml-
18PROPERTYWTIHINMFTOPTR&FOLLOWING: �D.wtmwapk:
SALTWATER❑ LA D IUM/CREEK❑ POND❑ WETLAND❑ lIUS0HA IUTNOPF❑ STREAM❑
TYPE OF WORE: NEW Ig ADDITION❑ ERATqli❑ REPAIR❑ OTI®t ❑
USE OF STRUCTURE/Amisr.C,Cweewmm4OcJ
ISUEE: PRIrtARY�SEASONAL❑ NUMBER OP BEDROOMS�NUAID®t OPBATRROO"
IEATEp STRUCTUgEE? VBS MWD YP9lA+pN*"fk HGO
DFSCNBE WORT_ s .J
SQUARE FOOTAGE:d.w..m
ISi FLOOA�JZC ,qft 1ND PLOOR'lf�'!fp.ft 3RD PIADR_q.R HASPMENT_a9R
pgCl(_q.ft COVERED DECEq;Lz NFR STORAGEq.R OTHEReµft
GARAGEW_q.RAm W$ benched❑ CARPORT q.R.farched❑ DerpdN❑
MA JFACTLBIFD HOME INFORMATION: b1 COPIES OF THE FLOOR PLAN REOUIMEW
MErw MODEL YBAR LENGTII
WIDTH BEDROOMS BATHS SERIAL NUMBER
EN QNMENTAL HEALTEI'
SEWAOF/SEWPR SOURCE: SEFnCJQ SEWER❑ EXISTMG❑
PLUMBMGIN STRII[.'NREl VPS� NOD (/yw,mmch co�lercd Winer AdeOupry Fom
PERIMEIERTOUNDATION DINS PROPOSED? MIL NOD EXISTING SQ.FT.
EXISTINGBEDROOMS PROPOSEDBCDAOOMS� TOTAL BEDROOMS Z
gVNER x}ro.Je�ee tln:sudniseknMMsvW iXmmMMn mgmiANe tlepvah Wx«psnA mva:mrt MY✓xMWnM>vAYBy _.
ypnelure eebw.l tlMen ual am eye onveM NMrtletls.MI m sWaEbnblw Mb pmel bq b W NexaM n pmW�L Ilw
eNemBo perml[9on min pn me ena::.«pa�uae.mapuN Bmmew:+mpr«pupa mman+:awtlbp nu.qqa«m.wxaNpal
�e«exmxme,repreeenli uixme imom:xne pmJAea i.emmb e!ppm.e:Mp>•e+«rm�ionb.®.:m uw.eo..e�Aem win
ma.wnro�li��eo�.anahel�w�e�mr.eemoem°q�,,bemns�ullBwtlMwx«u�npnue mp.wmepnra.«ppnponwmpteo
eP or
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.(MASOR
COUNTY CODE 14.08A1) {_/Z
'T� f"� d Ippetl Mtlw OWNERI �"�+.«�
.D∂tEN'LN..REWEW :APPROVED I DATE DENIED... DATE.. TAGS(NOTFS/CONDITIONS'
BUII.DIJODEPARTbffiNP
PLANNING DEPARTMENT
PIRH MARS}IAL
PUBLICHEALTH
r cc
7
Ul
�.` m Doz
® ��F g� :ar•�+l�l � I I I I � ��PSlri
D > 0 L€ Rl
I- mv
Nom-u € pia
na
�' = N §mH
zCA
OOwma" 9 Pfn;
7731Gm
vow Oo N 4 �. H
v+ m a � Y � � � 0
C.J m n O w gn
Rm N asz < Aa
o� O D o m w ID
N p ^� aID
A Go � U) F
�1
03
,G
![� O. zl
N N W
� rn V o a � •"._� �y� is R _: w nOC
9
0
J m w C
II » S N —
Q m C m
� » w
m