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w <br />:I <br />_ :I <br />�. <br />. `t <br />:i <br />• . 'i <br />.�: <br />. � 1 <br />::i <br />a <br />. ; <br />�; <br />e <br />-.... - <br />T <br />• ' <br />. •� <br />,I <br />. :I <br />' 1 <br />.. <br />! <br />. ._.. .. . �'. .� <br />flbILDING PEA.9IT APPLIC7ITION �' <br />�' , l�pplicant To Complete Thi, 5orm �% ������ <br />. / i � 7�� �� <br />if nore than one buildin is to be contructed, submih a se arate �j <br />4 p pr_rmit applica- <br />tloa fos each buildin�. A separate petm:t will be is�ued for cach build uiq. <br />� Ovnet �J/ �j/5 /�rr� i4�be r� Duilding Address tP%�1 ��?��-�-�(��, �Q� <br />).9dress �iJA7�er/c5i,�r� /�r� Lot�� Etlock /Z • <br />CSty FGP<fJ'�_ phone Subdivislon (Platj /�,.�,p�./�� /,/��� ti p��, z <br />lsehitect/rnyineer � . <br />City Phonc Metec � Dounds (C�nplatted) <br />Contractot S�iFr%/�irr i�i.�r.:�^�c,�� c'c• Sec. G+ 7L�.�_ Rgc p,5'- ' <br />7✓]dtn,'.G /3�f' /"1N�•�,sr.[ . . , <br />City ��='he r� _ Phone � �-3 - %� 7,� Huilding Use _ � '•; .`� �. <br />-&tate Licer.se NcwSer j.2,; �o/_Cj�/,- DescriUe Work 2o IIe Done -��S%iilc `�.� . <br />Ezpira�_ion nat� f' —/ — 7G ' � ' i . ( liN s � ��r.c• �. . <br />. • SICETC}I PLOT PI.AN DELOfJ' • " <br />' • . <br />• ' •� <br />� e <br />� <br />.:. • <br />;. <br />Ote of Duild:.ng <br />❑ Nea ❑ Addition � Repair/3er„o�el <br />. <br />Valuation c: Construction $ , K�•� <br />P7AT PLAtd ,REQUIRL`fE:lTS , <br />Indicate lot size, nane of s:reets, <br />3.ndicate location ar.c wi�:h o: <br />allcys, locate ar000�ed ar.d all <br />existin9 buildir.gs, sho:a distances <br />to property lines, show distanees <br />between buildings. <br />Lot size x <br />Lot arca Sq. Ft. <br />Sizc of E1 g. _ Sq. FL. <br />Numk>cr of Stories <br />Dasement <br />Signed Ry �/!-�y ��,i,(,.�� <br />For <br />Ownez Yhone <br />�_ 'ItfIS I,7;:F.-POR <br />: �tc ��ccived 1 / T � � <br />Pla:� C:icck :7cr..Saz %�.~�'` Z.7% <br />�(L7 <br />Valuatio� ' U�ti%('� <br />TemiE PCC =��.� ' �5.� . <br />�`c � <br />Flan Check Pee /� <br />n J <br />1bta1 Fee Duc � `�• <br />Datc Is�ucd • <br />Ucc Sor,e <br />F3rr 2onc <br />� <br />Occun�ncy Grcu, J�_ <br />Typc uf Con�trnction '�' � N. <br />OccuponC I.oad <br />Sprini:lcrn Required . <br />• • cirv or �vra�Tr <br />APPROVfU fOR GUILDI\�G PERMI�f <br />, Dotc...7_��-./=7,,r'--�y.-�_S�______ <br />