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- _ _ _ _. _� <br /> j 95�/3 <br /> • If more than one buildinq ia to be contructed, submit a separate permit appli a/�/'f <br /> . tion for each buildin3. 11 separate permit will be issued for each buildinq. <br /> ; � Oraer G�Y:1C �J �ia���rL���: Huild3ng Address ��=Ya. 1520 y.�;�,�.� ' <br /> . r <br /> , , Mdress � 91 5 ��b a�•• �. J\Y � Lot 21,�l L�3 t�i,3 c Hlock 3 1 `I . <br /> City _C-�c�-. `� Phone3i3 l 7� '� Subdi4ision (Plat) �e v.,�Y.e,� o�,� 15� : <br /> . � � � � ' n�f• :H , <br /> _ • Urehitect/Enqineer �.' � ., , o,� <br /> :..I ' <br /> _ ':: �j City �� ��y�! Phone �= /� 4 Al•4�; Hetes i Bounds (Unplatted) <br /> , Contractor C• v�a.� w Sec. Tap. Rqe ' <br /> . " address 5 ? ; - . • . <br /> �. �tY Phone Huilding Use �� t { �<c. ' <br /> �� • <br /> ' ��' <br /> ;� State License Ntsaber Describe Work to Be Done 2 �' S�ce� ��� .� <br /> � . . . Y.( <br /> : i Expiration DatB - <i�, �����, . � <br /> �� ' � � SI�TCH PLOT PblN DELOW' • - <br /> _ • � <br /> , ' i . • <br /> � � IIce of Building ' <br /> , t . . <br /> � • .. " • : • . . � �New [�Addition ❑ Repair/Remo�el <br /> ; , . � � £"._ <br /> ' • � • . • Valuation of Construction $ -� �' <br /> • , <br /> �`.• , . . • - PLOT PLAN REQUIRE.�LS;IT5 . <br /> .. , <br /> . � . <br /> . ' � � - ' Zndicate lot size, nane of streets, <br /> � . ' � indicate loca:ion anz width o: <br /> ;,-i • .. . • allcys, locate �zoposed ar.d all � <br /> existing buildi:qs, sho:a distances <br /> ' • ' �� � " y • ' ..' � to property lines, show distances <br /> � � � ' between buildings. <br /> � � . <br /> , . . ' Lot size X , <br /> � <br /> .�- . Lot area Sq. Ft. I� <br /> ,� •:. - � • Size of Bid4• Sa. Ft. �� a`r�;- <br /> • • Number of Stories <br /> ,- . . i_ • Sasem�t <br /> �� � �Signed By�. '�� \ ' ` � ,�,� . <br /> � ' Por 5�.,..� <br /> — � <br /> , Owner Phone 3 �-� � ,� <br /> . � DO :70'" S�:2ITB B'LOU THIS LI`7E-POR CITY USE OiIL'! <br /> Date �eceived (�'�Z 4'��],{� Uce 2onc �j�-z C_��t���i,U�,-L /y� <br /> � <br /> Plan C:ieck :�a.Ser 7'�-7 7( Fize zone ,3 - <br /> Vaination ¢U� Q06 '�S` ' <br /> . � Occuoancy Grou� . <br /> Pem.[t Fee /��, �J � <br /> Type of Construction <br /> ��z• � . <br /> Plan Chcck Fee Occupant Load <br /> , ibtal Fee Due L'Sc� s� Sprinklezs Required � � <br /> . Datc Issued • � � 7(/ ' ' . : . <br /> . , <br />