HomeMy WebLinkAbout1107 BUENA VISTA WAY; ; 63-5274; Permit~ N? 5274
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Front Yard Set Back Driveway Permit Required Yes ( ) No (&Fee ..................... ...............-
Side Yard Set Back No ( .................................................... Grading Permit Required Yes ( )
...... Mailing
...... Mailing
Address
Address
Number Street Cit c7
... ............................................. City Phone
To Construct 0 To Add /To Alter CI To Repair To Convert To Move From
Type of Const. L..&%qtion ...... ...... No. of Stories ............... i5 To Be Used for ...............
(Frame, Masonry, Etc.) (One Family Dwelling, Store, Etc.)
Floor Space of Proposed Construction (sq. feet) .... //&.-a .................. Const. Valuation $ ...........................................................
attached 0
Floor Space of Garage (sq. feet) detached OConst. Valuation $ ........................................................................................ ......_ ......
LEGAL DESCRIPTION ........................................................................................... -. ............................................................................................................................... ___.__
Lot Block Subdivision
or .................................................................................................................................. Section ................ v: ..... T~~p ............................ Range ............................
Located at ..L/p.7.......................... ........ Street, Near ...... ....& ....... ............................................................... ”7’ Assigned House Number
LAND AREA ...................................... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE .................................................... (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION? YES../ NO .................
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
...................................................................... ..................................................................... I Rear Yard Set Back - Sewer Disposal Plant Capital Cont. Fee f
....
,, i I
......................................................................................................
Distance Between Bldg.
Off Street Parking Spaces
Sewer Pumping Station Capital Cont. Fee ...............................................................
Sewer Main Line Cost
Sewage Disposal System
Zone - Residential ( ) Water Stocked Lands Charge I:
Zone - Commercial 1 ) Water Main Pipe Line Fee
Eng. Check By
Variance
Sewer Lateral Connection Charge .............................................................................
......................... ...............................................................
Water House Service Charge
Water Meter Charge ........................ ...............................................................................
Sub Total
Plans AppWi.OL ...................... ....... Plan Check Fee ........................................................................................................
aQ Approved by ..... t ......................................................................................... Building Permit Fee ... 3 59f ..............................................................................
d-e, Date ..............-.... 7 ....-.................................................... Total Charges ...9............................................................................
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