HomeMy WebLinkAboutAPPLICATION - 16-00052 - 250 W 1st N - 12 Plex - Bear Building 1 - East04
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�� CITY OF
�° RExBuRG Please Complete the Entire Application!
..-_..___ If the question does not apply Ell in NA for non applicable
Americas Family comvnuniry
COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION
35 N Is` E, REXBURG, ID 83440
208-359-3020
PARCEL NUMBER:
SUBDIVISION: (We will provide this for you) Addressing is based on the - must be accurate) UNIT# informationBLOCK# LOT#
OWWEIt NAME CONTACT PHONE #
PROPERTY ADDRESS- >ar ; a)
PHONE #: Home
Work
_Cell_ zGSs%Z/N7
OWNER MAILING ADDRESS: 0?& ,5 ?vcx J` CITY: L��.t?4zur r STATE: 1!5 ZIP:�s
APPLICANT (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application)
APPLICANT INFORMATION: ADDRESS
CITY:
STATE; ZIP EMAIL
FAX
PHONE #: Home Work
—� Cell
CONS:
MAILING ADDRESS: 3 F y`T j 2v, G J2
CITY l �unl� STATE !b ZIP'�`r�
PHONE: Cell# Zoo Sir q. � � Work#_
EMAIL IDAHO REGISTRATION # & EXP. DATE
How many buildings axe located on this property?
Did you recently purchase this property? 4 NO ❑ YES
(If yes, list previous owner's name)
Is this a lot split? E5—NO O YES (Please bring copy of new legal description of property)
PROPOSED USE:U4,&J Cf"
(i.e., Single Family Residence, Multi Family,
var-agc, �r mmerclal, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under ena of e
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 hearings before the that I
Planning and Zoning Commission of 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 cityto enter upon the above -
The budding official may revoke a permit on approval issued under the provisions of the 7003 International Code in cases of any false statement or misrepresentation of fact
P mentioned property for inspections purposes. NOTE:
in the application or on the plans on which the permit or approval was based. Perot wid if not starkd within 180 days. Permit void if work stops for 180 days.
attlfre of klWner/Applicant
Do you prefer to be contacted by fax, email or phone? VKYE
Pkv
WARNING—BUILDING PERMIT MUST HE POSTED ON CONSTRUCTION SITE!
kes are van -refundable and are paid a la at the time of" notcom beginning Aw cam
City a[Rexburg'e Acceptance of the play review fee does vvtmvstltuce play approval
2