HomeMy WebLinkAbout1986, 06-05 Permit: 00011405 MHS|GNA-. URE
OF
OWNER 0RAGEN
.iOnAnDRESS
MOBILE HOMES
APPLICATION
DATE 6Z&
00011405
PH:
LICENSE�:
PARCELO:
ENSUS TR:
INSPECTOR:
PLAT-
LOT & BLOCK
FINAL
(jD254500
'47
006
PLAT NAME:
C,OIREUN AD"'
USE OF PERMIT:
MOBILE HOMES
APPLICATION
DATE 6Z&
MOBILE HOME PERMIT
Make Serial #
Number 1 Width 14 LengTh 56 Height 10
Number 2 Wid�h 14 LengTh 56 Height 10
Mzsc Desc : 131 C SC
TOTAL FEE
Fee
Misc Fee
$101.50
180.00
1.50
06-05-86 78V86*l07�D�
OFFICF COPY
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00011405
COUNTER AP
MOBILE HOME PERMIT
Make Serial #
Number 1 Width 14 LengTh 56 Height 10
Number 2 Wid�h 14 LengTh 56 Height 10
Mzsc Desc : 131 C SC
TOTAL FEE
Fee
Misc Fee
$101.50
180.00
1.50
06-05-86 78V86*l07�D�
OFFICF COPY
�~''~~ �~~'~u
w
191
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FEA
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DEPARTMENTAL REVIEW
Approved
Cond. Approval
pHold
Approval
Environmental Health Application M b
W. 1101 College
Room 200 61M f
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Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
Plan Review/ Fire Prevention
N. 811 Jefferson
Other (SEPA/Critical Material/etc.)
Fast Track/Special Inspection Information
Project 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 compiles d application is true and correct.
r
Signature Date
i
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