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. <br />_ . . _ . ,; •., ,....� <br />• �ppllcantyToyCompleteyThis•:orm ' ,•:c;- ,i <br />j. . . , , „ <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 <br />� <br />.� <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) ' <br />:� • � . � <br />.1 . �OLtIdCtO! �YN i� /�/�M[' ��.>i.�IrU�/Ye.�i [0 �C. i�f. RQ@ � • <br />� . � . . <br />= ' �. .1• �I@88 _�.�C �-/�1Nc�� (c.f. . . . . . . <br />Y Citp /=�,Q.�ry Phone 3s3 Y�7F' Bailding Use ' '•'*•;_t'� <br />., �� �:;: :.. <br />.. 4 �, .. , . . • .:,..Z. <br />�• r�- State, License Nw�ber �;j.P -o �- 9G 6e � Describe Work to Be Done� 1Z e�,_.1 � <br />., . —�. <br />•`. :'I Ltpiration Dat@ S- /- •>r.. 9,: � i,�__'�. -�L' v:1C' yx�� 3r,.._./' • <br />' _��' - <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,'"� . <br />j . <br />� • � �, - .',.' . .. • . . .. - ' • . . PLOT PLAN REQUIRE�tENTS . , ' <br />• : , . . • • •? <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 <br />. ,� <br />lbtal Fee Due 2.�% ^ �� <br />Datc Issucd l'�%��7/� <br />� ' . ... � �'—� � . . <br />a <br />IIcc• Za _ <br />Fire 2one ��_� ' <br />Occuoancy Cro� _ <br />9ypc of Construction <br />Occupant Load <br />6prinklcr3 Required <br />. . . � , . — <br />., ' �.. • . <br />� <br />r <br />