HomeMy WebLinkAboutBLD2024-01383 - BLD CD Environmental Health Review - 12/2/2024 Pe1TRIt No:
383
' A � MASON COUNTY ECEIV
COMMUNITY DEVELOPME T FiL
Nov 2 0 2024
BUILDING PERMIT APPL'Ct�n Alder Stree �10a;
PROPERTY OWNER iFORMATION: CONTRACTOR INFORMATION:
NAME:Nnamwerw Join Ja Nmm NANUL'oWaaaaso'd t
MARLING ADDRESS:33xelpP "MAILING ADDRESS:iNI as dalgw
CfrY:•ennanaew STATE:- ZIP:w114 CITY:wallan STATE.- 9P;N w
PHONE gI:60he1a61e3 PHONE: CE.LL:3P3a461M]
PHONE 02: EMAIL:trada@raNraecamdydbn.mn
EMAR,:hwae.iemoner�OmNlmm L&I RED gJoahehr9l3Ja
y�1
PRIMARY CONTACT: OWNER❑ CONTRACTOR 0 OTHSit
NAME . SMALL eb- ^.-on
MAILING ADDRESS 1091 as mla ra CITY Wier STATE'a!ZIP was C
PHONE CELL C. G
PARCEL INFORMATION:
i
PAACELNfIMBER(12 Digit Numbv)a%�] ZONING
LBGALDFSCRD'TTON(ASb:ev )nekx E t37 FIRE DISTRICT O r
SITE ADDUSS4 1 w asmadoal haem ar CrIya11Mul
DIRECTIONS TO SITE ADDRESS won-anon maapec m,d-nahwaRel heam ar,PmWiY In mM do M
IS TBE PROJECT WITHIN 3N FT OF SLOPES)GREATER THAN 14%: YESD NO 0 SNOW LOAD:—Paf
ISPROPERWIVITIEN200FTOFTHEFOLLOWPIG: /casaa0nmrgPy)�
SALTWATER❑ LAKES RNPR/CRPPX❑ POND❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑
TYPE OF WORK: NEW 0 ADDITION D ALTERATION❑ REPAIR❑ OTHER D
USE OF STRUCTURE(xcidm z Gnaw Cawam rrRRA E-)-"
ISUSE: PRIMARY❑ SEASONALB NUMBEROFBEDROOMS0 NUMBEROFBATHROOMSI
HEATED STRUCTURED YES la'holea*)D YES(Pa [,j d, ,d d EI NO❑
DE IUBEWORKnewynge w1N M1aemtl Inn-rppm erw mtleown.eeve
SOUARE FOOTAGE:Im-nM
I ST FLODR_eq.& 2NDFLOOR477 R.R. 3RDFLOOR aq.R BASEMENT_eq.R
DECK_p.R. COVEREDDECK sq.tt STORAGE sq.R OTHER—K.R
GARAGE303 1.R AaacMd D Da&0ad 0 CARPORT sq.R AoaeArd D Detached
MANUFACTURED HOME INFORMATION: e4 COPIES OF THE FLOOR PLAN REQUIRED*
MAKE MODEL YEAR LENGTH
WIDTH BEDROOMS BATHS SERIALNUMBER
ENVIRONMENTAL HEALTH:
sEWAGRISEWER SOURCE: SEPTIC? SEWER❑ 1 HEWO EXISTING?
PLUMBA`GINSTRUCNRED YESe NOD 7Y addmhcornplared R'aam Adegad1Foam
PIEIDETERTOUNDATION DRAINS PROPOSED? YES NOA EXISTING SQ FT.
EXISTING BEDROOMS 3 PROPOSED BEDROOMS 0 / TOTAL BEDROOMS 3
01YNER ecknon'at.vat,mam'sw-W Inemaeb IMamodam.,..ft as sYp w crasm mamh mroullm.M.b dadgemmo Naom YW
alPrehaa bebx.I dWaRiM I inn me miner am INNrer declare mad l am eroded to re-Ns this permh end to do M am. as goposed,I have
ohbinW perm4Yonlrun allihe irecavery-Nes.lnclu3na any exemml hdtlar or peNw MlnrereM regardng 1M1N po)e0. The vmer w Ieyl
rprewnlYNe,repmero MM the Imormetlon pwided'm acmala and Pnnb eml.Vgroes al Mae-CwntY a-aaato the edove dasdlbea pr-aly
d aWrtueP)kron ena Inpgded ra 6wd,W&P.bemnea rruA8wWxwMOraWgrliea wneouNm krM cwnmemaa vANln 1B0
am-x e-amxhen wan b auapmaee mr a pen-d Rao aaw.
PROOF OF CONTINUATION OF WORK ON THIS PERMIT 15 BY MEANS OF INSPECTION. INAC7WrrY OF THIS
- PERMIT APPLICATION OF 100 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED.(MASON
COUNTY CODE%0BA])
X 11/8124
SIgnalum a OMER(Mug ro slonad by the OWNER) Data
DEPAHTMEN'fAL REVH;W APPROVED DATE DENIED DATE TAGSIVOTE CONDTOONS
BUIDA`G DEPARTMENT
PLANNING DEPARTMENT
FIRE MARS[TAI.
PUBLIC HEALTH I t
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