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----- � .., <br /> � BUILDZNG PERMIT APPLICATION (�� �� <br /> J Applicant To Complete This ^orm � / ,� �y��� <br /> . / <br /> If more than one building is to be contructed, submit a separate per.nit applica- <br /> tion for each building. A separate permit will be issued for each building. <br /> Owner �r� �r� �ir� `��>_, �• �=- Build�ng Address i�lY/D �i;.-.tw<<i - <br /> Address ���ir /F«�.-� � �t /%- /,�' Block � <br /> City l-a�er>'- Phone �s� - '/ici Subdivision (Plae) <br /> Arciiitect/Engineer �;••��. 1 -fi���•�, • <br /> City S,�< L�..,<�_„. phone Metes s Sounds (Unplatted) <br /> Contractor /r� �«.� �-�J` �- T• Sec. 2Wp. Rge <br /> Address i� o �',.r �s"�S' . <br /> � <br /> City G��-�.-c7Y�"" Phone Js?- 9/9/ euil.ding Use /- -� / - ��_ <br /> State License Number ,� � i -e/- S��'�K Descsibe Work to Be Done <br /> ; <br /> Expiration Date -� >'c vc !� SY -�.. / �'«���fi�'� . <br /> SKETCR PLOT PLAN BELOf4 . • ��� ����� S' E/cc . <br /> Ose of Building <br /> �' ��°``"� '9vc -� ❑New ❑ Addition �"RePair/Remodel <br /> � • <br /> ' Valuation of Construction S�� ����� <br /> � � � . PLOT PLA`7 RE4UIREMENTS : <br /> • Indicate lot size, name of streets, <br /> � indicate location and width of <br /> I �So X /��? " alleys, locat� proposed and all <br /> � - existing buildings, show distaaces <br /> . 3 � � .� . to prooerty lines, show distances <br /> , ' , between buildings. <br /> '�. Lot size X <br /> �� I <br /> � Lot area Sq. Ft. � <br /> �. Size of: Bldg. Sq. Ft. ` <br /> ��'• Numbe: of Sto�ies <br /> :.. w: Sasement � <br /> n � '� <br /> � Signed By -� �- �� ' <br /> �� For f-�-/�s�. ��'r-� , <br /> Owner Phone _ <br /> DO NOT :a':27':G DELO[4 1'HIS LINF.-FOR CITY USE Oi7LY � <br /> �ate 2cr.ei-;ed �-4 =1 � ^ U�e Zone <br /> Plan Check `Iumber �S .-� � � Fire Zone � <br /> , :� 1-�' Occunancy Groun i - I' <br /> Valuation I '� . <br /> Perciit Fee '72,� o � � '1'Ype of Construction -r � �y l_ , <br /> Plan Check Pee 4�� N Occup�nt Load � �`� — i <br /> Total Fee Due Il �f . � �7 Sprinklers Required -- <br /> ' _ ' <br /> Date Issued � <br />