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<br /> •' �' ' ' DQILDIIJG PCRMIT nPPLIChTIOtJ . . ,�' � .�;j
<br /> _ • . � Slpplicant To Complel•c Thia :'o[m . • ,.�]
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<br /> � . . If tsorc than onc buildinq !c to bc contructed, submit n .^.epazatc permit appli•. ,-
<br /> . S tion for cach Luilding. �1 separatc permit will bu issucd f.or cach Luil.diug.
<br /> ' ' Owner °�"' �� j�V � ' Duilding Addsess ��/-S"i 7 /1/+„nc 1�/-.
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<br /> ' 1lrldresn �a `/J �2ir�kc. /"-!, Lot � G ' Dlock 0 �'v �d-QU _ _ .
<br /> • ' • ' City L��r2��- Phonc /�/ �%- /b `i(, �ubdivision (Plat) � �YoL� __ •
<br /> ' • drehitcct/Enqinccr �y'cc�zu�� � ' '
<br /> •;� . ''°� City . f'.��...� Phone _ .Fletes L llounds (Unplat-ted) ' ;
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<br /> ' . ;,•, Cantractor _S'v.[ /- Scc. �wl�• R9� .
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<br /> - � ;. . � �dresa • � �
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<br /> l' -.Qity Phone 'guilding Use ,(�l ��e,,,c..� ' • , : :.���•. :.
<br /> � � .�'�� � Statc_Licensc tlia�bcr � Descr3be Hozk to IIe �Done ���c� bG�� ` ,
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<br /> : �1 ExPirition Datts • i�( o+�.,, '/u.�,f�,n�c�� . �� • ' r'
<br /> . o� ' '�� : SP.DTCI{ DLOT rravi nsT_oc�r• . •. . . _ � � .
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<br /> ' Dce of Duilding
<br /> �. � ' .: : , � : ; ." � . .� ' . , ; �Hew ❑ Additio:. (�Repair/Remo::el
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<br /> ' '' .l.0 16f�;^. �� •'�' Nr ^ "�' . paluntion of Const•ruction $ i,?`t1 %' �
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<br /> ' � . i ;a�re':� � . • � .
<br /> , �a' � t� . � :PIAT PIJ�t7 xeao�xL::::Ts .
<br /> 1� ' . � G �� I�� � . . • 1. � . . • •.A
<br /> • . � ,,•. __ � . �. i � .. „ �
<br /> ,; ; IaJicate lot ai.zc, nane af. r.tree..^.,
<br /> •� •�- • , � ' � � •indicatc loration ar.d wi.cth o:
<br /> . 1 . •- � �,; ,• . .
<br /> i. . •` • '�" alle;�s, '�ocate nroposed ar.d al l
<br /> , . :•"f 1�� ' ' . '_I '. ' ' � \ .u::icting builrtinq„ shoa di�:tances '
<br /> :.. � .1 � • ..:�� � - . � :��b�'� f�� . �� •. . -.ta pru�er.y lines� show di.ctnnee�
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<br /> ' `f •-• - f betwecn huil�ings.
<br /> . � � �- r - �ti . .y. . ,: . . .
<br /> . I � �: i ' I.ot tize _ x .
<br /> ' � .�= �' � : ' I+�1l�1�. l Lot area Sq. PL•. i
<br /> ' � �•' � • � �Sizc oi 131dg. ' Sq. Ft .
<br /> �� r.. '� . . ' : » - - . - 'I Itumbcr. of Storic, b..� _
<br /> , •,� �� . IIase:nent �wu•k _�__
<br /> �r, - I '• • . � Si�nca ny ��<:�'tt �1 ���lu-��{ .
<br /> 1, � f__. ._ _ _ ___: __ .-----�- T'� For � v •
<br /> • ' • Owi�cr Phonc
<br /> ' ' - PO :10+^ f•::27TI'i D�T.047 TIII$ LlPlii-20R C27'X US�: Oi7L'! � � ��� . .
<br /> Datc Seccived � Uce Zone __ __.
<br /> ' Pl�n Ctice,:.:�ur.,be!- ' � Fitc 2onc ^--_�
<br /> Valuation ' Occ•ap�ncy Grou� ,
<br /> Pcmit' I•'ec � _ ' _ 7yPe of Conrctruction
<br /> Plan C:liccl: Fue Occup�nl• l,oad ^
<br /> , ibtal 1'cc L .a r upr.inl:lcr� Ruquircrl �_._ � __
<br /> D:Le Yseucd — • • ; . � �
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