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, , . . .. } :..� <br /> • ( lOILDING PERMIT APPLZCATION . �� �� (�'��} ,i;t <br /> .' � •• t • Applieant To Complete This Sorm / / �'� _ <br /> .. . � . . � ,. �/l:sl]'s <br /> , . • ' 11 more than one building !s to be contructed. su6mit a separatc pecmit applica- <br /> . , tion for each bulldin�. �1 separate perm.:t will bc issued For ^ach building. <br /> / � /� <br /> , ' ' Ovner t��T -�e� (�l�� ,�s'��,( ,`�n� dnildinq Addrees � �_3 / S�« � /�-� c; � <br /> � <br /> ' , �ddzesa T:=:'=� C - /G� � c v Loe 2� ' � 3 Hlock /,- j �-- . <br /> � • <br /> • . City � v,.-�c,.� Phone?�� -c.�L.zy Subdibision (Plat) �in_,-.� i✓i5.�� <br /> � � , f . <br /> • �tehiiect/Enqineer � ����2-"�✓`-�� <br /> _ •i . `.�� CiLy • Phone Ketes i Dounds (Unplatted) _ <br /> , , � <br /> � . <br /> '. :,'. Oontractor � '� J n,a-Z`-. C<�. >� Sec. iwp. R4e <br /> ..� . <br /> - ;• . � Mdzess .�3 )-- � 7/ S�/Jw Sc_. • . . <br /> '1 City��/n/{�//-�E' Pbone �f'S 7�f/L� euildinq use . '•:_=��..Y <br /> � h� . �,: � � yyt�Z , . . . .. ..i.` .. <br /> �:r� � SWte,License Number 1�3- ��` � a 5 R� Describe Work to Be Done /�i�`-'c�-e- — <br /> � : , J Lspiration DatE ��3/�7 � ' ,�<-.� ' U �d �� ��� - <br /> �� ' �' � � SICETCH PLOT PLAN SELOIP' • • . <br /> . + •.� ' •: � Qse of Buildirig r <br /> �. i ' . ' ,' , . , , L�New ❑ Addition ❑ Repair/Remo:<el <br /> . '� . <br /> ' •'{. . ' • ' Valuation of Construction S <br /> '� ' : . ' .. . � • .' • . PLOT PLAN REQUZRESIENTS � . � • <br /> r.• . • , . .. . � . . °., <br /> � . ' � <br /> � � Ipdicate lot size, name of streets, <br /> • •� � . � • •indicate location and width of - <br /> , � • •' . ' ` � alleys, locate pr000sed ar.d all - <br /> . ;.'j ' _ " � . existing buildings, show distances <br /> ' � r- � • .�: . to property lines, show distances <br /> ' � �! . � � '. • • betaeen buildings. <br /> . � � _. . . <br /> ' ' . . . • � Lot size x <br /> � � � . . . . Lot area Sq. Ft. <br /> ..i� <br /> ; � Size of B g. Sq. Ft. <br /> �� � � . .• Number of Storie's— <br /> . •,: ,� ' , Sasement � � <br /> �r.. ;/ � <br /> �� ._,•�' � Signed Sy . �� >•��/ �-•� �� <br /> � • . _ . <br /> ' . FD��/.1��•-� C�F••-c.Tli-- Go. oG��c"'�- <br /> ' � 9aner e ona r- � s / <br /> ' DO :10: SC:tITL BELOF! THIS LI:dE-FOR CITY USE OfIL'L <br /> Date Seceived . Uce Zone <br /> ' Plan Cyeek :iur.Ser ' ' Fire Zone ' <br /> Valuation Oc, uoancy Group <br /> temit Fee iype of Construction <br /> Ylan Cheek Fee Occupant Load • <br /> . � Total Fee Duo Sprinklcrs Required � <br /> . . . <br /> Datc Issucd � . , . • • - <br /> • � , <br />