1999, 03-23 Permit App: 99002182 MHProject Number: 99002182 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Date: 3/23/99 Page 1 of 2
Project Information:
Permit Use: DOUBLE WIDE MANUFACTURED HOME -
EXISTING SINCE 1982
Setbacks: Front 71 Left: 8 Right: 12 Rear: 20
Site Information:
Plat Key: 000000 Name: UNKNOWN
Contact: BURRUS, GLADYS & THOM
Address: 19218 E MONTGOMERY AVE
C - S - Z OTIS ORCHARDS, WA 99027
Phone: (509) 9284310
District: G
Parcel Number 55082.1107
SiteAddress: 19218 E MONTGOMERY D
OTIS_ORCHARDS, WA US
Location:: OTI
Zoning: UR -7 Urban Residential -7
Water District:
Area: 9,200 Sq Ft Width: 80
Nbr of Bldgs: 2 Nbr of Dwellings: 1
Review Information:�.:..:..
Owner Name: BURRUS, GLADYS & THOMA
Address: 19218 E MONTGOMERY AVE
OTIS ORCHARDS, WA 99027
Hold: ❑
Depth: 115 Right Of Way (ft): 50
Department
BUILDING
Comments:
Review
Site Plan Review
�K tea. a;ltached srTE
BUILDING
Comments:
Plan Review
HEALTHDISTRICT Septic System Review
Comments:
.5 i A -N DA9- 4LVe a1
Sewage system designed
for 2— bedrooms only.
Permits: smosmossemwwwwww.ww.
Contractor: OWNER
Address: 0
000000, 00 000000
Item Description
STATE SURCHARGE
INSPECTION FEE
COUNTY SURCHARGE
Manufactured Home
Finn: OWNER
Phone: (000) 000-0001!
Units Unit Desc
1 Y OR BLANK
2 SECTIONS
1 Y OR BLANK
Permit Total Fees:
Fee Amu,nt
$• 50
$ll c :10
$2 00
$12 50
Project Number: 99002182 Inv: 1
Application
THIS IS NOT A PERMIT
Penalties will be assessed for commencing work without a permit
Payment Summary:
Operator: RMB
Permit Type
Manufactured Home
Date: 3123199 Page 2 of 2
Notes:
Printed By: RMB Print Date: 3/23/99
Fee Amount Invoice Amount Amount Paid Amount Owing
$126.50 $126.50 $0.00 $126.50
$126.50
$126.50
$0.00
$126.50
2(-1X (o0 MobiLe--
This site oai--, . peing sui.-.rmi!ed for tho purpose of
obtainin9 a ht„,,o,P(i perm!: and is a t: -:..‘ and correct
representation ot the proposal. All known property
lineskiirnepons
.U.) liney., st.17.ictureE, and easements
have born11-igicf,+H;tid. AISO tnucated are ;wiands,
bodies of water, ,i-:--ep slopes or ottirrcritical areas.
, i/
Signed: __ i,
-
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vs -r( tQG
Cmtki2-46€.
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MoN) o ea_LI
Aoatipcog (kkot\rr-Gox
ZONE L4.-7
ROADWIDTH 5 o
FRONTT7/ FLANKING
COMMENTS C-
REviFwFn R