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� � � SOILDINC PERIiIT APPLICATION // <br /> . ,� � � , Applicant To Complete This ^•orm � /j 7"��� , <br /> ' It more than one buildinq is to be contructed, submit a se arate ���}/S <br /> tion for each uildin n se arate P Permit applica- <br /> 9• p permit will be issued for each buildinq. <br /> . � . / n <br /> , pmer -___�"»� t- 4 � ��",�l ,�_�Buildinq Address � �Q�C .��C��i ��A,,.<<�� <br /> . Mdress ,7�,� 0 ) �,y ' <br /> . — ( � '�- _r� ('� � Lot '� Blxk . <br /> i <br /> City ( C �Ctr�phone,� i�J Subdivisian (Plat) ; <br /> . � - �rchilect/Enqineer � <br /> • :, `"� CitY Phone <br /> - - "j Ptetes L Bounds (Unplatted) <br /> , Contractor �.a�.�c� *�-�,��� Sec. T,,p. RQe <br /> _ , . , Address j� 7 0 � . �- ^ .� . I <br /> '. �tY Z�' Phone,�J�� �"1/ L- Buildinq Use ' <br /> •.� � � ::': -ii.' . ... I <br /> ' rt Slate License Number ,j�.fj'3-d/- �'/yA i'i Deacribe Work to Be Done `"� ; <br /> , �I hpiration DatQ : <br /> . ��: . • SICETCH PLOT PL71.N BELOW' • - , <br /> . ' I • , <br /> � Ose of Building ' <br /> :.1 •. �> �' � " � . . <br />- � + ��ir�f.N-Lt�`✓�-�L� �. . . . , ' �New ❑ Addition ❑ Repair/Remo5el <br /> � ! •/ ' �n0O � � ' 'naluation of Construction S ' <br /> • / <br /> .",• � . � � • • P7AT PI.AN REQUIRE?IENTS '� <br /> + � � � • • Indicatc lot size, name of streets, � I <br /> . . � . ' ' ' indicate location and width of <br /> ' alleys, locate or000sed ar.d all <br /> � ,i y—� existing buildings, shota distances <br /> • ; `I � y `� ' - � to property Lines, show distances <br /> ' ; �D` � /� �Qa�p • between buildinqs. <br /> . . � �.��-c�-�.�0 �� ,�:. ( ' Lot aize x . <br /> "' { Lot aiea Sq. Ft. <br /> �� r.. rj^ j � . G�....o�.�,^.� / r-��,. Sizc of B 9• Sq. Ft. <br /> � �' � '� f �^ � Number of Stories <br /> � . f� easement <br /> `� = Signed By <br /> +. <br /> ' ' For <br />� , Owner P one <br /> , UO NOP Si:tIT� 9ELOt! THIS LI;IE-cOR CITY USc O.7L'! <br /> Date �xeived _ Dce Zone <br /> ' Plan Caecfi :7ur,ber Fire Zone - <br /> Valua:ion Occ�oancy Croup <br /> PemiY Fee Type of Construction <br /> Plan Check Fee Occupant Load <br /> : 1b1a1 Fee Due Sprinkler3 Required <br /> Datc issued ' ' <br /> F <br />