HomeMy WebLinkAboutBLD-90-375 k' , TOWN OF MOUTH
MATTA IIC
!°3/4•00p.�SS dc'.%" Application for a Permit to Build No. 3<
UPON FINAL APPROVAL \g MAP 9? LOT bl"i�
FEE MUST ACCOMPANY THIS APPLICATION. DATE
The undersigned hereby applies for a permit to build / a' / 90
according to the following specifications /2/ / �/90
1. Name of property owner TOkMU .1 # eL/3YDD _ -Novi 33'tb
Address 1 5-7 UV 10N $ i ti
2.Name ofArchitect(ifany) /V ,f Tel.
3. Name of builder _ i -4- Address
4. License No. 2/ A- Tel. 4-
5. Name of Mason -____ -YlJ - Address -'6219-.nJ
6. License No. Tel. ////��
7. Construction address 4' A-- alcor kyfru o9(- k
Flood .A D
11
8. Date of subdivision Approval /VA plain zone Zone
9. Private dwelling El-' Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 In la �� �
6
S7ar
11. Commercial 0 Sri " Kitchen
12. Other ❑ Dining Rm.
13. No. of stories Living Rm.
Bed Rm.
14. Foundation — Full ❑ Half E Crawl Slab ❑ Sp.O z7 Bath
15. Materials — Wood 0 Cement 0 Other 0 2 Deck
16. Type of heat — Oil 0 Gas f�Electric 0 Other Closed porch
17. Garage —•1 0 2-0 I.1' Family Rm.
L Sun room
18. Swimming pool - Size /V,4- Garage
19. Staraagg�e�, shed, Size Shed
tove-
20. 3Wo d I�Coal ❑ Alterations
21. Size of lot: No. of feet front 27 S No. of feet rear /GD _No. of feet deep 9--7/0
22. Size of building: No. of feet front No. of feet side 4-t" No. of feet rear
2a Distance from nearest building: Front Ft.side Ft. side Rear
24. Distance back from line or street 7 5 From rear lot line /t"A- Side line i -X- 5
LOT RELEASED BY Signature pii- -I a -
_
PLANNING BOARD Address ZS -2—�
Date //
PLOT PLAN
I.- `^-
FOR LOT #
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) e
3 I '
Well 0ittifio /lei �
� Aaa-a—
not ft rear)
C
Abuttor's Abuttor's
Name IName
Lot # T 1 of n Lot #
1(u SIO
bIU4-r ' ,A924
AR YARD
If this is a t — If this is
corner lot, ,t . ..... .....ft. corner ]owrite in namePrjt write in
of street. t e ia4 L I name of
4. I iL other
¢ w street. .
w • c rd
ro
1J Fret&
SIDE YARD SIDE YARD '
HOUSE • •
0_ _ _ FT_ 0 a FT.op
•
4 •
SET BACK
ft.
A •
I -A
•
(lot ft. frontage)
A
/ (NAME OF STREET) •
•
/ \ Information / . _n , A
/ \ Supplied by / �
MARK NORTH POINT