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. � -- . . • atirtoi��c rL�uu1� nrrr.icnTio�a .' . , ��j'�% ��-,�,�.•t - -
<br /> -- • . � _ -' . . -' 11Pp11canL To CompleCo 1'hxa Norm , . , � . / .�.••�
<br /> . i � � •.� ' //i��/y`i
<br /> , • • IJ tn�rc than one buildi.ng i� to br. r.ont.rucCr.d, submit_ n �:cp,yrate pcnnit applicn-
<br /> � . . t:oa for C�CI7 6uiAcSin.7. �1 separaLe pennit �aill bc i::�ued 1:or each builciing.
<br /> � . • Lnmet V a__��� /-�`l�bF�a tq �a.,J'�jt��ing Addres� <s`J- D - C CI �jrh�c � _ '
<br /> � • � `
<br /> - � 1rldzCSE :�..`.c��L`4-1,f`'L. u T i r?_ 7-28- � 9 nioCx 3 � .
<br /> � CStyZ(�-�;_�f.r phone Subdivl.�ion (Plat) /��-� (� � � j �f1' ij��
<br /> _ � • rschitect/Engincer � � .
<br /> ' :..I '
<br /> _ _ .i City Pl�one F:etc� s IIound� (UnplaCted)
<br /> i
<br /> � . ;� Co::tractor �,o i.,r.'(�n ✓ /-�('���.Scc. •n.�. R,�� �
<br /> = ;. . ; �::�t�,5f�rc9F��: s�� • . . .
<br /> .. + -CityFvZr��Tt Plion��Z-/i>� Duildiuq U.c � ��? , . � � . � .
<br /> . i' . . . . .1:..'. .'::'. ..
<br /> . �j:� � Stttc,Licencc ih:r�ber z2�-a/-���� DescriUc t4or}; to Dc Done �' ya�,.`" �,1�
<br /> : �•. �i Ez,iration Data �/ /bf�i S � �orG� �ld��{'• f�ac� y ��..k��� T/Ot,
<br /> ;i: :i . .�
<br /> : sr.r,Tcu rr.oT rr,��� n-r.ow' • � ,(Q �.� �C'/e ra--t ,��T-� -
<br /> . i.� • ' . _ . . — � � .
<br /> • Ose of Duilding
<br /> -�� . • . ' ❑New � Addition �yRepair/Remo_cl
<br /> . ,, - , • • , c'
<br /> � . ' • � . • � Valuation of Construction S CSU U . •
<br /> • . ' .
<br /> �. .. . � ' . . . . � - � . , 'P7/JT PLAII REQUZRE:�IENTS _ .
<br /> `. .' � � • ' Indicatc lot size, name of streets,
<br /> ' ' � � ' ' •indicite locitivn and aidth c.`.
<br /> ' :�.� ' _ �^ . � � • allcy::, 'locatc pronosr_ti ti::d all �
<br /> � � 4 � ��exi.^,Ciny bui)di.^,qs, sho�i di�tancc.^.
<br /> . l .'! ' ... � - .• 'a : . . • �•�� � • , �.to piopm-ty ).ines, show distances
<br /> • � � ' � q � . . � ' .. betwecn bu:ldings.
<br /> . , � . ' . ' • I,ot eize x
<br /> . . � . --
<br /> ... . . .. - � � . Lot irca , Sq. Ft.
<br /> �• r.. . . • �G3ze of H1.�9. Sa. FC.
<br /> � . , . � 2:umUcr o.`, 5toric,—
<br /> . :7 . i • . Da:cmcnt
<br /> :..
<br /> � �=' + Si.gned ny , �q
<br /> _ �� �
<br /> S, . , �--� � ,
<br /> • • • ror
<br /> ' � . ' CA:nc:z � Pl�unc —
<br /> ' � __ DO id0.' f•::217'I: 9�!AI7 TIITS T.I;Iii-iqR CTTY USE OiJ7.'! . .
<br /> : _ Datc .^.�ccived 7 � / ]�� _ p�c 7.rnie _ --
<br /> ' Flan C:�ee;; tlur.,ber ' Fire 7onc � •
<br /> 1'aluation ' l�i�i��� �-` Or.cun,�ncy Croup "�
<br /> Pcl�i.t Pce � /O• P.G—� q•y�.e c+f Conr:CrucLion JC_- �--1 --
<br /> Plan ChecL• Prr Ocaup,int T�o�xl '
<br /> ' , iUtal Pcc Duc .__ � �_ f,p.rinl:]cr� Rcqui�.-���ITY_Q.f_�\�FREfT --
<br /> Dato s�;r:nrd ' • APPROVED fOR [3UILDING PERMIT
<br /> ', ' _"__�_.._�.._------ • �: �o�to�.��/_�i—or K '�; -
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