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_. � � I EOILDINC PERMIT APPLICATION ' ' <br /> • Applicant Ta Complete This Poim /�r j �� <br /> . It moze than one buildinq is to be contructed, su6mit a separate permit applica- <br /> � tion for each buildinq. n separate permit will bc issued for each building. <br /> � �" Ovner ��/� ,,,_ /, � _�� /j „ /� Buildinq Address �, �; > (",(p ,:,� <br /> - �� n �� <br /> . . aaaresn _� G / 7 r'�.c�. � / _ ,� r.oc 7 F' .� aio�k �; �' .� <br /> _ , <br /> CltY �r�r. .�i.� // Phone �5 ,R /( 73 Subdivision (Plat) �11: �i7� P// /Q � �� <br /> Architect/Engineer /�77 t,�_,• , ,f ,,, Q , y-- �d r / s�- <br /> _ :; City Phone Metes/i Bounds (Unplatted) <br /> , Contractor 7 e / .k' Sec. 7r,rp. Aqe <br /> _ Jlddrees , <br /> City Phone Huildinq Use ' <br /> � .. '�, . . <br /> . ,,j Stete License Number Describe Work to Be Done �` <br /> i �piration Dat� �� � <br /> � ��� � r / ' l u // Cl .-Cv <br /> ��: S7CETCH PLOT PLAN HEL019' � �,7,�c n - <br /> . ' I � . <br /> � O�e of Building ' <br /> � � . ' � . . ❑New � Addition ❑ Repair/Remodel <br /> � . " Valuation of Construction $� °i <br /> e <br /> �"'' � ' '� PIAT PLAN REQUIRF1dENTS <br /> : , . <br /> ' ' Indicate lot size, name of streets, <br /> � , indicate lacation and widtt: of <br /> . ' . alleys, locate proposed and all <br /> � t � ' exiatlnq buildinqs, show distances � <br /> - � �� '! • to property lines, show distances <br /> � , � . • betveen buildinqs. <br /> . Lo! eize - S C x <br /> , <br /> " Lot area Sq. Ft. <br /> ' r.. • • Size of B q. �_ Sq. Ft. <br /> � tiumber of Stories <br /> :.. <br /> . � Basement <br /> • �: Si9ned By ��� �./' �.�s. <br /> ; <br /> � For <br /> Owner Phone � - -'�' <br /> DO :70': SiZITG H�LOP7 THIS LI:JE-cOR CITY USE Otii'L <br /> Date �eceived � �J ] Uce 2one <br /> Plan C:�eck `tur.:ber � Fize Zone • <br /> Valuation �-L° ' � 6� Occupancy Group <br /> Peznit Fee �?, ¢U <br /> lype of Construction <br /> Plen Check Fee ` Occupant Load <br /> � Total Fee Due 4� , �-°U _ � <br /> Sprinklers F:cquired <br /> Date Issued ��3�'] 5 ' ' . . <br />