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' . . .• � . . . . ' � ' 10ILDINC PERHIT APPLICATION . . , :�, .� , �„
<br /> • , • �pplicant To Complete This :orm • /��•�� ���
<br /> . , i ,
<br /> ' =i �ore than one buildinq ia to be contrueted, submit a separate penait applic� -f '/s�
<br /> � .. , t1on fos each bulldinq. A separate,permit vill bc issued for each buildinq.
<br /> . '
<br /> . • ; ' Oraer ���S_�,� / CJ" '�"Gi/�/ <�T I Dnildinq Address ��`�s' i �' �e' ,� q )�'
<br /> ' . : aaa:�.. lR'? h' � %.• �/,, .y u,e� � �Z i� Slock / •
<br /> : .—
<br /> , . �� C1tr GV/_ -r F �r� lhone.;S?-uS'°!q Lubdivision (Plat) /U,�J��'.�,cJ �r�.J
<br /> _ ' � � �eehitect/Enqineer � .
<br /> � �•� �=`t �tlf • Fhone lfetes i eounds (Unplatted)
<br /> _ t
<br /> . � • -
<br /> :,' Cootractor ' �, �, gya •
<br /> � y "' ' • •
<br /> ,. . �• lddress • • .
<br /> ' •i .
<br /> t atY Phane �aildinq Ose C��'::-�, '�"�ti.sC.� i.:!'
<br /> . . 4 . . 'w..�. ' . . , ..,�a;Jf'.:.
<br /> ' • .� i;� itate.Licenae Nmober Deseribe Work to Be Dona ��
<br /> ; �:.i. �piration DatB ' Ga',v� ;;� -- -��-� / ��y
<br /> �.�' '� • % LRETCFI PLOT PLAN BELOW' � �. .YL1�tJ - 7�L '..M.t1X .UOc�.�/'7" ..
<br /> � . •�.,:� • • , , � �
<br /> Q�� oi 8uildinq t
<br /> ! i . . � � . • (�New ❑ 1lddition �tAefiair/RemoGel
<br /> . . . ,1 ' - . . �' �,.� ' ' ' �. � � �. `D (j � .
<br /> • � � . ' • • . � • • Valnation of Construction S �.� �'"" •
<br /> i � ' ' . �. ' . � � . ' � .
<br /> y, '. , ' . . •:' . . . ' � . . lLOT PLAN REQUZREPSENTS _ .
<br /> . , � . 'X
<br /> , ' �� � ' ' . : , . ' 'j'. • ' Iadiaate lot size, name of atreets,
<br /> � ' •iadicate location and width of
<br /> ' �'� ' . ' : ' • '+•:= j ' alleys, locate proposed and all �
<br /> • • ` i'� - . ' � ' • . - -' existinq buildinqs, show distances
<br /> . i : ' ••��' �""'�9 : • " • � . . t0 ptoperty lines, show distnnces
<br /> , �. _ ' . • � ' • between buildinqs.
<br /> ' � � ' Lot size x .
<br /> , . , . •
<br /> .•{' ! . . • LoL area
<br /> � r,: = • '. � Ei:e of B Sq. Ft.
<br /> q. 6q. Ft.
<br /> �� � , , . ' , ' Itumber of Stozies-
<br /> �: • ; ' � . • lasement
<br /> � �r..� . .
<br /> + �_`• . � iiqned ey
<br /> ' � � :' ' . �.
<br /> ' . ' • . . . Tor, �.,, a
<br /> � • � � � . , ner P on
<br /> � . • �
<br /> -. � ' . __ DO NO".._TCiITS BELOF7 THIS LINE-FOR CITY USE Ot7L'f '
<br /> - •-. Date !:eceived � � S Oce 2one
<br /> ' , P1an.Check .�urber ' lire 2one '
<br /> Vdnation �5D � Occuoancy Group
<br /> !emlt Fee `J. � iype of Construction • �.
<br /> . .' ' llan Check Fee Occupant Load •
<br /> . ,: Rbtal Fee Due S • � Sprinklers Required
<br /> Date Issued � /9 5` ' . . ' , • :
<br /> 5. ,� - . . . � ' � , .. . • ' . . . � � . . . . - �
<br /> . ' ' � . . . .' . . . . . . � • . . � . ' ' .
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