HomeMy WebLinkAboutAPPLICATION & SITE PLANS - 05-00253 - Mountain Archery - Site Plan~~~C;II'Y OF REXB URG •
BUILDING PERMIT APP~ATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X322
PARCEL NUMBER:
SUBDIVISION:
(Addressing is based on the information - I
PERMIT
Please com le ~h~entire A lication!
P PP
If the question does not apply fill in NA for non applicable
( We will provide this for you)
UNIT# BLOCK# LOT#
nust be accurate)
OWNER: B~' `r/ . ~ 1L CONTACT PHONE # ~S ~ - c~ly llo
PROPERTY ADDRESS: ,33 ce/!~' 1.t9 i%1 /t ~i. r/-~.
PHONE #: Home ( ) /~,fG~Bp`z ~ Work
OWNER MAILING ADDRESS:
EMAIL
FAX
CITY: ~ ~~ STATE:,~ZIP: ~3y O
APPLICANT: (If other than owner) ~y~ ?~ /J, i~~ ~ ~•-J
(Applicant if other than owner, a statement authorizing applicant to act agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS !S/3y/~ ~~O ~ CITY: ~ cr+'' ~•
STATE; ~~~12d ZIP 8.~yy~ EMAIL FA~.2~~3SG-~irZ f~3
SSG - Sl
PHONE #: Home (se8f 3SG~~1yCS0 Work Cell (CZd~ 7D j' - ~~~5 8
CONTRACTOR: ~ ` r i~ . ~ Oi1Sfi'~ • o.TJ ~„ L Cr,
MAILING ADDRESS:/y39 `li,' ~oQO,~~ CITY Su Qs-~, STAT>{~ZIP~~~~~'
PHONE: Home# ~S6-,~,s~ Work# 3SG ~~y.~~ell# ~O~ - ~ysa
EMAIL FAX ~~G -"GS3 Z
How many buildings are located on this property?
Did you recently purchase this property? No ~ (If yes give owner's name) ~o~a sr'! , ~~~.
Is this a lot split? ~ YES (Please bring copy of new legal description of property)
PROPOSED USE: ~9~ ~'~1,1
(i.e., Single Family Residence, Multi Family,
Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalty of perjury, I hereby certify that I
have read this application and state that the information herein is correct and I sweaz that any information which may hereafter be given by me in heazings before the
Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulations and State laws
relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes.
NOTE: The building official may revoke a permit on approval issued under the provisions of the 2000 International Code in cases of any false statement or
misrepresentation of fact in the application or on th~lans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work
stops for 180 days. _ ~ ~~
/p~/ /
SignatEurebf Owner/Applicant ~/ d' DATE
Do you prefer to be contacted by fax, email or phone? Circle One
WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non-refundable and are paid in full at the time of application beginning January 1.2005.
City of Rexburg's Acceptance of the plan review fee does not constitute plan approval
3
h~
O
~~ ~• L
~~I
i
i ~?
I O
__._i
i
f
47
Q
F ~
I
h~,'
4
v
Q
~
6+ N ~'~,
9- Q ~
~
°~
-.
~
~ , I
~
~ ~
I ~'
........
_-. _. .
~ .
~
O
j _
O
i - ~ ,
- ~~
`
i
~ ~
`~ ._
FII
Y
U
O W
m °'
_ M
Z
~_ o
~ ~
~ N
(n Q'
U a ~
J
-' O
U W
W ~
o Z~ Z cYi ~ W
oQZ `oao O~-W
>m ~ ~ N ~ U O Val ~ ~ >
~> W '~ W m ~~ OMO O N ti O Cfl J~ Z
n- 2 Z M~ O a00 N O O O N ~~~~ Q --~ >
~ f n Q M~ d' M M M N ~ EF} N O EA ~~ N Z
s+
Z' ~ 7 ~ 7 V
R ~~ ~~ O~~ N ed d
'd ~' v Cf *k v O E 0~~ ~ C
_ ~•_ ~ G~C)Q dQ Q•
Z d~ ,C ~e0 y N~~ A N d
a v1 a a~ D ~ F- F- V C9 J
•~
c -.
` w
~
_. ~,
~-
6
~'
~
~
:.._..,,w.w..~...
c~
o , ~~_';
-~ ~. .. _.
W ~ 4
~'
p `?
~,.~........ _. O _...,.~ ".... _..
4 L
~
O ", p
•-;
~_
Q. a .~. ....._
• •
r
,,:,
Q2o ~
~.
~_
m
r
tl
ti
^4^",'1
V~
05 00253
Site Plan MTN Archery
33 Winn Dr