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<br /> __ � � . � . � . ' � ' . HUILDING PEIUIIT nF^LICATION � '�/��! ' ' t .j
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<br /> , , : lippllcant To Completc Tlii� :arm /
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<br /> , • • ' I! tore than one buildlnq is to be contructed, submit a ceparate �crmit applica- .
<br /> . : tion for each 6uil�lin�. �1 separate permit will be issucd Lor cach building.
<br /> . ?R' o�raer 1Q�,1=,PE'/� �(.� �G?ET Suildinq nddress ;��;Z� sCfl eSTN u� '
<br /> ,' • , lddress �_a,�..5"C'.����V rir Lot f 'J slocx 3�'�.�, . �
<br /> . City L 'L Phone,25��-5"35�`� 5�bdi4ision (Plat) ��
<br /> _ � • ixchitect/Engineer ' -----� • • . • ,
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<br /> _ 'i . . ._�i City Phone Mete:. c Dounds (Unplatted) •
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<br /> :,'. Contractor � ' Sec. TWp. Rqe '
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<br /> � ,'.' �' lfddress ' • . ,
<br /> .. 'f City Phone Duildinq Use � �� o D /�/� • � ��• '' '
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<br /> r State License Nuz�ber Describe Work to Be Done �..�L�Q /Q Xl��` '
<br /> � • �t Ezpiration Datt � ' � �+ '
<br /> . � ��(�_lrt. . ,., w T ,...�,a_l i
<br /> v�' '� , • £KF.TCH PLOT PL71!I DELOW' • _ !" �-- �T T O P � O � � '
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<br /> � Uae of Building _�} 0 7 y� �
<br /> � . , ���.� : � ' ;
<br /> �' i � I�Ne�� Q� 1�ddition ❑ Repair/Remo5el
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<br /> � i� j:• • ` , • •'^` Valuation of Constzuction $ 0 �.
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<br /> �►� ' ' �. � � �•'v� . �' � PLOT PI.nN REQUI?tESLNTS .
<br /> y . . .. . . . :;
<br /> � ' �� � .
<br /> ,• ( � ' ' : 1 � Irdicate lot sizc, nane of ctreets,
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<br /> ` � ' •indicatc location anfl widtn o:
<br /> • • �' ' • �� ,�. i: �� ' .c '. � � j�� . • allcys, ' ,
<br /> � ,/� locatc nr000sed ar.d all
<br /> r,� � . existing buildi:qs, shc:a distances
<br /> , 1 '� •.'' '" , . � "'l, `.s:'' to property lines, show distances
<br /> ,. � . : � � � ' , � � , between buildings. .
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<br /> , , Y. ' ' .y . Lot cize �_x �o'�' �
<br /> � ' '•i' , ! • . � � • • . Lot arca � Sq. Ft.
<br /> • r.. � . • . . • ' - . Size of IIl g. p � Sq. Ft.
<br /> '� � • • Number of Stories 6-rt,�-,
<br /> ' �� � � �' � ' Aasement '}-�,r� -
<br /> .r. . � /
<br /> �� •;;•— • �Ci(� V\ ycSigned ny .,� . �./ . K-�,T .�
<br /> ' y� . �►"'r � Z . ��-�\b�- �+ For -
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<br /> . � • Own Phonc '
<br /> .. � DO VO': StiZ?TE AE:.Ol7 THIi LI:IE-FOR CITl US& OilI.7 � .
<br /> Da[c `:eccived � tlsc Zone
<br /> ' Plan Check :lur.Ser ' Fire 2one J' '
<br /> Valuatt.on Occuoancy Croup `T_ _
<br /> Pemit Fce Type o� Con�truction � }��
<br /> tlan Check Fce Occupatit Lo�d •
<br /> . � lbtal Pcc Duc �_ Sprinkl.rr� Required ' � .
<br /> ' Datc Icsucd • , , , �
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