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<br />• �ppllcantyToyCompleteyThis•:orm ' ,•:c;- ,i
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<br />' If more than one buildinq 19 to be contructed, submit a cepazate ocrmit applica-
<br />.. tlon for cach 6uildin�. �1 separate pr_rmit will bc issned for each building.
<br />. • dmer �ii +� �i.�e :'L- : � _ � , �_ Dailding Addresn �'Z> c �, /// �„ [,../iZ f
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<br />� J�Edress �32a. S�>�.�N �.vh�i h'�l Lot r:1 Hlock '
<br />. Ci /- y Ph nbdib i .
<br />, ty -��.,_ f one S is on (Plat) 11..,:>.- � N, //.!
<br />� 1[ehiteet/Engineer �• i�i i, �v c-.s -�
<br />_!'�,+:.`..� City • Phone Ketes t Bounds (Unplatted) '
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<br />.1 . �OLtIdCtO! �YN i� /�/�M[' ��.>i.�IrU�/Ye.�i [0 �C. i�f. RQ@ � •
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<br />= ' �. .1• �I@88 _�.�C �-/�1Nc�� (c.f. . . . . . .
<br />Y Citp /=�,Q.�ry Phone 3s3 Y�7F' Bailding Use ' '•'*•;_t'�
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<br />�• r�- State, License Nw�ber �;j.P -o �- 9G 6e � Describe Work to Be Done� 1Z e�,_.1 �
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<br />•`. :'I Ltpiration Dat@ S- /- •>r.. 9,: � i,�__'�. -�L' v:1C' yx�� 3r,.._./' •
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<br />�.�" � • S1�TCH PLOT PLA+! BELOtQ' • -a�..l'�.e. �
<br />. ,f '� . • . . , .. • Ose of Buildicq '
<br />a ` � ' , :, ; ' . � • � , ,,, � � ❑Hew ❑ ]lddition � Repair/Remo:el
<br />. . ••, .4� .. t: •��' ' • , • . iQaluation of Construction o,'"� .
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<br />� • � �, - .',.' . .. • . . .. - ' • . . PLOT PLAN REQUIRE�tENTS . , '
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<br />:. � • • ' • � �; : � . , • � • • _ ' Indicate lot size, nane of streets, .
<br />_ -. , ,) . � , -: . , ' • i. � •iadicate location and width of � :
<br />�•� allcys, locate pronosed ar.d all
<br />. • _•�� ' '� ' '' • existing baildinqs, sho:+ dis:ances
<br />, ? i �. ' .�:"�'- � � • � ' . .�°+. • . . to ptopertp lines, show distances
<br />• � � ' betveen buildings.
<br />�I.j � � . . . ' • . . .
<br />, ,; . .� . . .• . . . .. . • ' - Lot size x •
<br />� • :.i• • . , . ' • • . Lnt azea � Sq. Ft.
<br />� : � Size of H q. Sq. Ft.
<br />.. 'i � • • . ,' . . Humber of Stories
<br />• :: . j ' . . • ' " ' , 8asement
<br />'�`�� . ' • . Signed SY �.i�G:�:J 9C �C.�.�.-,,�
<br />• y�. • . . • • � •� ' � • For �.'a- � � iv�„..�_,,
<br />• �w6Ft P one
<br />NOT h':2I?'� BE:.Ot! THIS LI:�E-FOR CITY USc Oi7L'L �
<br />Date �:eceived ' . /0�7 )�
<br />' Plan Cheek :lunber �— '
<br />• Valuation 2.E�1 @�
<br />. . . • Pemit Fee ��Q� -'
<br />pl+n Check Fee
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<br />lbtal Fee Due 2.�% ^ ��
<br />Datc Issucd l'�%��7/�
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<br />IIcc• Za _
<br />Fire 2one ��_� '
<br />Occuoancy Cro� _
<br />9ypc of Construction
<br />Occupant Load
<br />6prinklcr3 Required
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