1986, 07-01 Permit: 00011915 MHS|GN4TUREC�F
OWNER ORAOE
mR annnFsy
MOBILE HOMES
APPLICATIONDATE 7—/-P(.,
MOBILE HOME PERMIT
Make Serial #
Number 1 Widt hi 14 Lengh 48 Height 10
Number 2 Width 14 Lenh 28 Height 10
Misc. Desc , SURCHARGE'
TOTAL FEE
Fee
Misc Fee
$101.5O
100.0O
1.50
07-01-86 35725 *10.506
OFFICE
*
CITY: ST:
PH:
f'9 920 4954
LICENSE -
ARCH /ENG IN EER:
R
PLA
LOT BLOCK
IINAL
PLAT NAME:
-ZONE*;
TONE
USE OF PLRMIT:
JOB ADDRESS:
MOBILE HOMES
APPLICATIONDATE 7—/-P(.,
MOBILE HOME PERMIT
Make Serial #
Number 1 Widt hi 14 Lengh 48 Height 10
Number 2 Width 14 Lenh 28 Height 10
Misc. Desc , SURCHARGE'
TOTAL FEE
Fee
Misc Fee
$101.5O
100.0O
1.50
07-01-86 35725 *10.506
OFFICE
*
4-1
IN
J
J
J
J
Fol
X10
DEPARTMENTAL REVIEW
Approved
Cond.
Approval
Hold
Environmental Health Application N 3- I Z W. 1101 College
Room 200
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 compile said application is true and correct.
F
Signatur Date
7 V
a `<51
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c
I -7
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