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.. • , } � � eOILDING PEAHIT APPLICATION .�� •/��.�� ` <br /> _ � JlpQlicant To Complete This 'orm <br /> . . 9/%/� <br /> • if oore than one buildinq ie to be contructed, submit a separate permit applica- <br /> � . . tlon for each butldin�. 11 separate permit will be issued for each buildinq. <br /> ' � Wner U/I� B/L � i1?D,��A.d Suildinq Addreas ,�o�,/� /�/i'YF � <br /> , � �eat�.. 3a.ZS cco.a,e r.ot � � �s sio�k 7 S� � <br /> City �✓L/C�77" Fhone RSa-3//3 Subdi4islon (Plnt) �; L,frya Cos • <br /> ' • �reAiteat/Enqineer � /� ,v-no. riniN ' <br /> _ • :+ '.'.'i City Phone Metea i Bounds (Unplatted) <br /> ;, Contractor ' Sec. 1vp. 1t9e <br /> - , . � Mdre�a • • • <br /> . _ • � <br /> f City Phone euildinq Use ' ':.,� .., <br /> '� Stata License Nucober Describe Work to Be none ' <br /> � _ <br /> , . . 'I Lzpization Date ' 1i,i s r.cc-Z 7o"i'� C.koi.�/ � <br /> :� ' I� - SRETCH PLOT PLAN BELOW' _L����l �G'NC� <br /> � • . + ' .� � Qse of Buildinq j <br /> { � • <br /> �. ; ' , :' , � I�New ❑ Addition ❑ Repair/Remo5el <br /> ` .� IO <br /> ' ' ' • i � � � • ' Valuation of Constzuction 5 .5 DD ie-- <br /> � : � .� • PIQT PLAN REQUIRF.�(ENTS �: � <br /> ~ •, i ' #�s �� • Ipdicate lot size, name of streets, • <br /> � f • \J indicate location and width of <br /> , � `� C alleys, locate pr000sed and all - <br /> ;.� " a� �� , exieting buildinqs, show distances <br /> � . ' to pzopezty lines, show distances <br /> ' f � between buildings. <br /> � • - <br /> ' � Lot size z <br /> � � �T ? s� . Lot area 6q. Ft. <br /> � � 61ze of B g. Sq. Ft. <br /> �j '�" Nutnbez of Stories— <br /> , . ; . �' ' Basement _ <br /> :.. __---- <br /> .� ._. —' --- -- - ---- Signed By �f�. ���-� <br /> ;. � .� R P <br /> For <br /> � ' owner e one _ i <br /> � DO :IOT ti:2ITG D�LOFI THIS LI9E-r^OR CITY VSE 07L'L <br /> Date Seceived r// �/f 7� � Oce 2one <br /> ' Plan C:�eck :lur.,ber `� ' Fire Zone ' <br /> V�luation `���� � , ` Occuoancy Croup <br /> Petnit Fee �� � � Type of Construction <br /> Plan Check Fee �"'" Occupant Load _ <br /> ' ibtal Fee Due � U G 6psinklera Aequired <br /> � ;�L��7 ' � . " . <br /> Datc Issucd . • - <br /> • . . � <br /> II <br /> � <br />