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<br /> t.Applicant Complete All Sections 11_;r•vv This I tt:^ t. w
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<br /> IComtrrtcrcir:l/InuUSi.rial Sir ucturt I$t001.. 'Additi(trt/Alters,iiontoC-c.rnrct(rcial/Iit•a:tstrial Sing lure $200 '` � V
<br /> 'Accessory Structure(6.t age,Stud,etc.) ' $}.',t)t 'P.(kiitton VAR crat ion toAccessoryStructure ($iS I
<br /> Ace c;spry St rticttire(Coni)rterciat/indsistri?.l)E$700 lAdditior,/Alteration to Bunkhouse $)
<br /> �. . ._Yv Deck/Strut./Patter/ttr iritti!et; alJ/Stitt walk Ili .,,1r i $250, . _ _.�
<br /> Driveways/&C.ampgr(n,rirt Structures $).1',1 IV rt St.ttc.Statute 59r92(1v)Structures „��}�.. $350 t-
<br /> Filling/Grading I$550 r t:oathotre $`,tat lam,
<br /> -Solar Panels(Stand alone or roof mounted) 1$}`.0`E Permit I xtensi(rn(}Year i)(tension• Mc.avea One) $700
<br /> NOTE:After•the-fart permits(permit acquired after constructing has begun)may coat up tottf c . tE roc,th w, 1 t f-:::. It
<br /> 'rl.0irilritllrifuiifiir lowers,(!tr"iro:r)U Permits&Signs require a different application form;see corresponding application,and fees. r-^ 0 1:
<br /> *lterns not lisicd ohoue will be in-:off-floc accessory structures,such as:pergolas,landscaping,etc_ Z f
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<br /> Property Owner's Name:- M4 L 14-e-t(>1 13€NEO1 CT
<br /> Property Owner's Mailing Address:, 4841 C.41M(3�t1 p e— RD. SttAdear?�t /b1N SS3� gPi
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<br /> Property Site Address: 5+0 t L'Qt� 6 �. U 'i v�y W I 54 83 o _ < y f!
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<br /> Contact's'l'elepnone Number: ATr
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<br /> Contact's Email: (M�et.�1G"T e_ &M41 L . C o M �**If staff has a question about iit's a pplieatio.) you wilt be.corr!acic d via moil. Make sure your email acid'ess is R
<br /> legible and you:detail pi ovidei wilt accept edit;its f;ttt.t tits following aldt:;t,�s:@R t.utcttC o t it.y.org aid `; °"
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<br /> i:e,;;)I ta ril,rnn of Poverty: _ i
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<br /> Sc 1ion if: Ze Town 7:41 N Range ll: I5 W Town of: S VJLS S 1� :,
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<br /> *Attach additic,cl page if ne....':-d fear-lengthy description OR attach a copy of the deed OR attach lax system property page.* '
<br /> Tax ID It(1-5 digit number; found on tax statement): 21 (p t°1 __
<br /> Proposed Use of Structure/Addition: 5.T,024CIE/(PAQJ'-I466
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<br /> Anticipated Start Date: Av G. I ,Z,O L _ (llome/Cabin;Commercial Business;Bedroom,,Deck;etc.) i
<br /> Building Conirat• ,,: 51'EvE MCC143.% Sewer Installer: ^ In
<br /> A1tJ':A 11111,OW'I-II IS i,INI t'OI1 LAND SEt. \'ICES STAVI'CO t1RMLN'I'S`CONDf'I•}ONS ONLY
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<br /> 1,ojA di i r5 vleeelec o/ $ef74'c - 44 r.'d !a-/II R3
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