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. . . _ , , . <br /> „ �, � . . �� ' ' EdILDING PERHIT APPLICATION � , � / ��7� ti7�a�y . ,i;i <br /> , , • IIpplicant To Complete Thi� :orm b U •^ , <br /> .. . • � . . O /�7�'�. <br /> • • � 'If more than one buildinq is to be eontructed, subntt a e ara[e / � • <br /> . tlon for eacl� buildin ' P Pcrmit applica- <br /> , � �. �l separ`tc permit will be issucd for each building. <br /> . i � Ovaer � � � _ Huildinq Address ry��, (�. �.,y�� �..Q- ; . <br /> � . , ( _ <br /> � � � � Mdress , �' Lot ,QP�� � °c� I elock �' <br /> . � . <br /> • , , �tN�*'<?Int � Q Phon �' - � Subdi�ision (Plat) �!-�C�1'iY �ry.A �f�_�. � "{ <br /> _� � � ltchi�ec Enqiaeer ��- ' . � (�' ' . <br /> , — ��' r�� C� .1 �[�Il o��� . <br /> � t� ��i • Metes i Dounds (Unplatted) <br /> _; .� , ._ City __ Phone '�_ . <br /> :� r� I • <br /> .;��, Cantractu� n�`t�(l'�(�C�. d�� lR h �,,,Z Sec. YWp. Rqe . <br /> � � <br /> �• � ,' '��' Mdress � �< 1 P � ' � , � • . � ' , : <br /> �� «tY ���`1�Q4 `; .r< �- � ; �., <br /> • 4� Phone ,�-1�1 Hnilding Usc :'.:��- <br /> �r� � State.Llcense N�..^sber `-��--�\`-. � ���2� �scri� {Pork to Be Done �� 'l <br /> ; �I Ezpiration Datt ��- 1 -'1 j� �—� � ( � .}7y��e Q ' <br /> `��' � � • • SRETCH PLOT PLA!I IIELOW' • - <br /> • t•� '.�� • • , . � ^ r <br /> Dse of Building <br /> !' i • � • � , , ,,, � � []Nea ❑ Addition ❑ Repair/Remo:Iel <br /> . . ,;' • . i' <br /> , t' . � . • • Valuation of Constzuction $�� ' <br /> '• . . . '. � <br /> .�"• . � } " . - • .' . . - ^ PIAT PL11tf REQUI?tE.�L:7TS <br /> „ . .. . . . :�. <br /> t � ' ' : ' ' • • Indica:e lot size, nane of streets, <br /> ' ' � ' ' " �indicatc loca:ion and width of <br /> ' • � � � . '::� � ' • _ : j. • elleys, locate oroposed ar.d all � <br /> ' � ;�! • .:� ,_ � � � : . =� • existing buildings, sha.o distances <br /> • � �� • � • � to property lines, show distances <br /> . �. � �. . ' , . betwecn buildings. <br /> , . � ' ;' • . ' • � Lot size x . - , <br /> :.i- � , . . . . Lot area <br /> ' : . Sq. Ft. <br /> �•. r:. . . � Size of 8 g. Sv. Ft. <br /> � . ' • Number of Stories <br /> .r,. ' :•. . j_ � . � - . � . • 8asement . . . <br /> . ., �- <br /> � .: Siyff� 8 _ <br /> y. . , _ ` <br /> . . . For_- ��1���-�.i._.�- ' <br /> • • , ' Owncr �hona^�'lel` _�i�TT��J <br /> .. ' � DO :]OT ICiITS DE:.OF7 THIS LIN£.-•POR CITY VSE OIIL'L � <br /> � ' ` — <br /> Date Seceived � O:e 2one • <br /> ' Plan CSee� :7ur,ber ' ' Fizo 2onc • ' <br /> ,Yaluation .,-��(�S�r,�- n Occuoancy Crou� <br /> Pemit f•en Typa of Construction <br /> Plan Check F'ce _ Occupant I.oad • <br /> . ; ibtal Fcc �ua Spzlnklcr� Requirod ' � , <br /> Datc Icsucd ' ' <br /> • . . . . . - <br /> • . ' ' . , . <br />