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_ � � BUILDINC PERMIT APPLICATIOP! /� , j:a_ <br /> � Hpplicant To Complete This Porm �� /� <br /> If more than one buildinq is to be contructed, submit a separate permit applics='/� <br /> tion for each buildinq. A separate permit will be issued for each building. � <br /> �e! �� � Building Address .-"� '� < .�i'i.' I i�� <br /> . Address _ Lot •/ S Block <br /> CStY Sh�iT- l� Phone <br /> Subdivision (i�lat) /J��, //c,;,�n <br /> Architect/Engineer � , �;� �--�� �h. S <br /> ' . , City Phone Metes 6 Bounds (Unplatted) <br /> Contractor � ��-� S' L' ( ; ;� �'�" Sec. _ TWp• Rge <br /> _ Addreas ' \,; r - '_ / : �� ��,� . <br /> /7c nc!';�in n <br /> City ,.�2_ ,�_� �y phone ^7-J-c•ti A�) Huildinq Use ' <br /> � State License Number IlS �^ / /i� j� Describe Work to Be Done <br /> Expiration Date //-i-� S ��y�� /�-���-� <br /> _ � SEETCH PLOT PIJ�N BE1Af4� • <br /> Use of Building ' <br /> �� , � ❑New ❑ Addition �Repair/Re:nodel <br /> � � Valuation of Construction $ .j/E' C' <br /> ��' • ' PIAT PLAN REQUIREFIENTS � <br /> � • Indicate lot size, name of streets, <br /> . indicate location and width of <br /> . � alleys, locate oroposed and all <br /> exieting buildings, show distances <br /> ' � � �� � to property lines, show distances <br /> a . ' between buildings. <br /> . Lot size x <br /> " � Lot area Sq. Ft. <br /> , ' �� � � Size of Bldg. Sq. Ft. <br /> ' Number of Stories <br /> � � Basement <br /> ` � Signe�3 BY �CIG•-•1 I 0 C� h�i— <br /> Por <br /> Owner Phone <br /> DO )!J: '•:�i':_ �'.>;,C{i :(Io L.'::E.-FOP. CI�CY USE O:IL't <br /> Date ..ece'_cn_d 1� . . �/�l�' ;Jce Cone <br /> �l�n C:�.c�:. .,,.,;.,,,r Fire 2onc . <br /> Vai��atio: _ _ Occuoa�cy Jroup <br /> Pemit Fee <br /> _ Type oE Construction <br /> Plan Checi: Fee Occupant Load <br /> Total Fee Due Sprinklers Required <br /> Date Issurd ' ' <br /> ��l� L�l' . l l'.�� � �- ���, �r/ - <br /> l <br />