1986, 02-03 Permit App: 00009582 Relocate GarageDEPARTMENTAL REVIEW
(
Cord.
Approved Approval
Hold
``
Environmental Health Application # i�"`
-; 3
.._/`//��
W. 1101 College
Room 200
' ` .(6/1g;---/
0
tcC/c c-ce�r c ,\..1
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
I
_
Plan Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Protect Representative
Phone
Address
I certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
Signature Date
Show on Site Plan:
Additional Information:
Lot Dimensions
Landscaping
Existing Structures
Drainage Plan
Proposed Improvements
Hydrants
Structure Setbacks
Topography
Easements
Lighting
Septic System (s)
Signage
Water Lines
Shorelines
Sewer tines
Highwater Mark
Fences, Wells
Driveway(s)
Right of Way Width(s)
Names of
Fronting Street
Flanking Street
f�-
ms: Attachments:
,
I
:
r
A
0