HomeMy WebLinkAboutPermit 170 - Black River Quarry - Batch PlantBlack River Quarry
western sand & gravel
OWNER ,�
MAIN
WIDTH
ADDRESS
PHONE
/�v
DATE
TYPE OF CONSTRUCTION
,t I ,yy�
BUILDING
X
_
BUILDE _� �?
+�
ADDRESS
FT. SO. FT.
ARCHITECT
ADDRESS
JOB
ADDRESS
STREET
DEPTH
1�UMBE a/
T 7 !7
OF
USE ZONE
LEGAL
�y7
LOT SIZE/
LOT RE
h
4u
BLOCK
LOT
YARDS
MAIN
SET BACK
SIDE YARD
REAR YARD
NEAREST
ACCESSORY
SETBACK
SIDE YARD
REAR YARD
NEAREST
DISTANCE TO
BUILDING
SO. FT.
I
BUILDING
BUILDING
I
LOT AREA OCCUPIED
BUILDING
PROPERTY LINES
—
_
O�
/0
G '
SQ. FT.
SQ. FT.
('LASS OF WORK NA/PLF ;/-Al ) ,*A/7
REMARKS DESCRIPTION OF ANY WORK NOT COVERED ABOVE
WAk NG Notify Building Department by Street Address and Permit Number when ready for inspection. Work must not be
cov ered before inspection and OK for covering has been given by Inspector in writing on Permit Placard.
I hereby acknowledge that I have read this application and state that the above is correct and I further agree
to comply with all City Ordinances, State Laws, and lawful orders of the Building Inspector governing building con-
struction.
Written Authorization of the owner must be pre- n / �� �,—,�,�
sented when work is done by occupant or lessor. OWNER /J< i b f 6 fe el' ? D T �
PERMIT FEES: (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY)
A /� HOUSE A OTHER MISC.
id6H�G'i A " GARAGE i G ARAGE S UILDINGS i FEES i ��f
BOND NO.— TOTAL FEES i BY EIYEi ,t��r G�� IT TE e l 9j Z / /_A4�Z___
NOTICE: THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PLACARD MUST BE POSTED PERMIT THE WORK
MAIN
WIDTH
DEPTH
AREA
TYPE OF CONSTRUCTION
BUILDING
X
_
FT.
FT. SO. FT.
SIZE
ACCESSORY
WIDTH
DEPTH
AREA
OF
BUILDING
BUILDING
X
—
h
SQ, FT,
EXISTING BUILDING AREA ----------- - --
SO. FT.
TOTAL AREA OCCUPIED
LOT AREA
LOT AREA OCCUPIED
LOT COVERAGE
—
_
O�
/0
G '
SQ. FT.
SQ. FT.
EXTERIOR
FINISH
OCCUPANCY
TOOK USED
HOW
BASEMENT
AS
1 A
�!
HEATED
SIZE SQ. FT.
ROOMS
TOTAL
BED
ROOMS
BATHS
LIVING
L•D
COMBO
DEN
KITCHEN
NOOK
K•D
NOOK
ATT.
GARAGE OFT. 1.1
4
VALUATION OF
Hw£ i
f
��
GARAGE i
HOUSE .ATT. GARAGE i
OTHER i
ALL IMPROVEMENTS
dd
FOUNDATION OK
FRAMING OK
FINAL INSPECTION
REMARKS DESCRIPTION OF ANY WORK NOT COVERED ABOVE
WAk NG Notify Building Department by Street Address and Permit Number when ready for inspection. Work must not be
cov ered before inspection and OK for covering has been given by Inspector in writing on Permit Placard.
I hereby acknowledge that I have read this application and state that the above is correct and I further agree
to comply with all City Ordinances, State Laws, and lawful orders of the Building Inspector governing building con-
struction.
Written Authorization of the owner must be pre- n / �� �,—,�,�
sented when work is done by occupant or lessor. OWNER /J< i b f 6 fe el' ? D T �
PERMIT FEES: (THIS SPACE FOR BUILDING DEPARTMENT USE ONLY)
A /� HOUSE A OTHER MISC.
id6H�G'i A " GARAGE i G ARAGE S UILDINGS i FEES i ��f
BOND NO.— TOTAL FEES i BY EIYEi ,t��r G�� IT TE e l 9j Z / /_A4�Z___
NOTICE: THIS PERMIT DOES NOT COVER PLUMBING, SEWER, OR WIRING INSTALLATION.
PLACARD MUST BE POSTED PERMIT THE WORK