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� _ � . � �OILD2NG PERMIT APPLICATZON ' � • ' �• <br /> . . , . , Applicant To Complete xhis _orm / �J�b `'t . <br /> • Ii more than one buildinq is to be contructed, submit a sepazate C/ /S''- <br /> • • tion for each buildinq. �1 se arate Permit applica- <br /> P permit will be issued for each building, <br /> �/ � <br /> ; � O�mer y1 0,��,� �1i�t � 8uilding Address �•��yJ J� <br /> , . )IdQress � ! ]-c' �,;,��-�-e-r�<-tr�.-. Lat -�!-��-�' L Hlock `�3 c� . I <br /> L / � <br /> � City �G�-ezr Phone <br /> Subdi4ision (Plat) ��_�-�� ' � <br /> . ' • Architect/Enqineer ' . <br /> _ "-� City / Phone Metes a Sounds (Unplatted) <br /> • :, Contractor ^'[ � �i+,ax—� Sec. qy,�p, Rge �' <br /> _ ' '_ �ddzess O-- - .�-o �J • ' . � <br /> '. City �i-ct�.� Phone '3-'�I—�z zLBuildinq Use /ie�`��„�t�, ., .� <br /> �'.i . . 1-2 3-- / .. :�•. <br /> � ' �;j � State License Nwsber � - -G�';'� pescribe Work to De Done �"��� � <br /> ; �I L�cpiration Datp / <br /> . . -Ca..-c��. p� ' <br /> . `�, � . � SiCETCH PLOT PLAN gELOW' • / <br /> , ' t . . - <br /> � . <br /> ; � pse of Buildiag � <br /> , ' <br /> _ " •� � ; • . . . . . ❑New ❑ Additio. ❑ Repair Re:r�;lel <br /> • , . . : <br /> � � � c ' ' .k�Q�� � • � tialtiation of Construction $ �a :� ��� �' <br /> � � .� _ <br /> �.• , . ,/1 v _ ' . � . . PLOT PLAN RF,QUIREbfENTS <br /> � . K. ,sy .- �� •�p . ^ . <br /> � � f � � , i�dicate lot size, nane of streets, . <br /> , j (,•�� f indicate location and width of <br /> ��'t • • � alleys, locate aroposed ar.d all <br /> _ � : ;� - - ����� � - Cxisting buildir.qs, shoto distances ^� <br /> ; �- � ' �"- to property lines, show distances <br /> ' ; , ! ' between buildings. <br /> ' • Lot size X <br /> .. . <br /> . Lot area g <br /> �J '" � . ' Size of Bldg. Sq. Ft. <br /> • ' Number of Staries <br /> .:. - i_ � • Basement <br /> .� � M Signed Hy � / d.c_ � <br /> � For <br /> . , Owner Phone <br /> , � DO NO'." S{:2IT8 HELOII iHIS LI;IE-20R CITY JSE OiiL'L <br /> Da[e Received �'_� - � �7 - �;� �� Ute� Zon� � <br /> ' Plan C:ieck :1ur..Ser Fire Zonc - <br /> Valuation Occuoancy Crou� <br /> Femit Fee Type of Construction <br /> Flan Check Fee Occupant Load <br /> . ; Total Fee Due Sprinklers Required <br /> Datc issued • • • <br />