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• . ti � ♦ . . , . _..r.. �..�� ! :. _ • -y <br />'� ' ' " ' � ' DOILDZNG PEAHIT APPLICATZON ' � . � •,; •• . ,ti,,? <br />- ' " �� ' � • � �pplicant To Complece This :orm � ' , •: <br />^••�� Zf more than one 6uildinq is to be contrueted, submit a sepazatc permit applita- ~ <br />.� 1: tien for each buildin3. A separate permit will be issued for caeh building. <br />. � , <br />.� ;' a�er ; � �j J-�'o r,� i� e v u+ S�ilding Addzess ;� J 3 7,t? v a o n vr o": � <br />a.,'\D : uaress a. c� 3 1 � v a a s�,w o'� r,ot f s} `"�—' Hlock �o• <br />, CitY % JPan�' Phane Snbdi4ision (Plat) 1-�,4 r!-4� 11Ei(ZS, • <br />�. . . � . . <br />: itchitect/Engineer r i ,' �,T L.,�.�; , ' . � . <br />_' 1:.°E� City n y � 1 v� A,�Phone �C� � i D �' 7 Hetes i IIoun�is (Unplatted) ' • <br />'� .;��; Coatractor �� j1r, yy� . K��Jy.�qrr'o 1 ie �; Sec. SVp. Rqe � <br />: , ' ±' •'• Mdress p U. 1� e 7� ) �� Z . ' ' , <br />.. 'r City r'�/n yr 7Ch Phone ��- 1"h ��7 • Bnilding Use'�10 I 11 I i� P D b ir ,/ ''��'�� <br />�- � `� � State License N�ber bescribe Work to He Dane �' � <br />r . <br />:.�'i LYpiration nat� '� U I I n ir ��r X� YY O 1 IZ � h • <br />�+.�' � . • 87�TCH PLOT PLA.H BELOSQ' • S�S 1.�%i� 11 D}�, �. IS JCC - <br />- �;':_� . .. • . .. • osc of suilainq moo ) Dvo'�u iS� <br />. ,_ <br />�� i � � ; � , .,, � • �New ❑ Addition ❑ Repaiz/Remo::el <br />��• ' " ." . � • ;.' • �Valuation of Construction $ 4-00� <br />`-� � '� � . ' �. , . . . „ .. • - I .. PLOT PLAN REQUZFt&•IE:7TS . <br />_�,. . . . . . � . . . e 4 . <br />� . � . ', . . • • . � . . <br />�. � • • ' ' � , , ' . • • • ' Zndicate lot size, nane of streets, <br />- • � ' ' ' '.� ' ' j. �' •indicate locatioa and aid.h o� <br />• . • j ' • : �;; ' - .. . :: • alleys, lwate ar000sen ar.d all � ' <br />''1 ' • existing baildi: gs, sho:+ distances <br />,. . . <br />� . i i . .�:`�'""-'!. , . • , .~'• • ' . , to property lines, show dis:anees <br />� . �: � betveen buildings. . <br />. '. . - .. ' - • • • : <br />,� �. , . - • Lot size x ' . <br />.. <br />' • �':•i' s • . . ' . - , . Lot area ' Sq. Ft. <br />' �. = . ` �:. - ' � . Siae of Blcq. Sa. Ft. <br />�� �� . • ' ' N�mber of Stories <br />• :: .i ' . - . . Basemcnt • <br />'•r� ' . • • . . : : Signed By � ' <br />. a. . . . . . . . . <br />, _ . . . . • . Foi �� 1� f�nw�i, e v Nt <br />. - . ' . Owner Phone� <br />.. , DO NOT SC:22TL D=LDI9 THIS LI:7£-FOR CITY US 02IL'! ` -. <br />. Datc �eccived � � II�e•Zone � ' � <br />. � �Z ' <br />' Plan C:�eck :7ur.ber ' ' Pire Zoae ' � <br />• Valuation Occuoancy Crov� <br />� Pemit Fee ' ' • Type of Constniction • <br />Plan Cl�eck Fee �' Occupant Load . <br />. � Total Fec �uc � Sprinklcrs Required ' <br />Datc Issucd ' , ' .• . � • , . , _ . <br />• • . . . . • ' • •' . <br />. . . • . • . . .. '•'. ''' ' • . <br />. .: . . . • . ., . • ' • <br />