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<br /> � " � ' • � ApplicantvToyComplete Thi� :o:m /� 9��/`�'/ , j • . , ,�
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<br /> ,� • ' ii moxe than one buildinq is to be contructed, submit a separate permit applica- •
<br /> . : tlon for each buildin3, A se�arate permit will bc issued for each buildinq.
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<br /> •, , ' Amct /1 rJ( � o ,) r-c.l /--.'/ Euildinq �dd,�e$s i�`% (� � ; � � t�; •
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<br /> t � . ' �ddress / ' � � Lot 7 :� 2� Biocx -�-;� ' 3 � �
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<br /> '• . . C1ty �J< >•- Fhone Subdi4lsion (Plat) �� �.,�.•J e,/v , :
<br /> � �echiteet/Enqineer � • �,� • �/ . • .
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<br /> _ ',',_• � • "_'� City • Phone Hetes i Dounds (Unplatted) ' •
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<br /> .,•. Coatzactor ///<.�,-, r- iU f✓ �'���.ni�V 5ec. 'l�,rp, Rq� .
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<br /> = '�. . 1• �ICSS �7�CIJ ���IN.�II w(r� ^l�' � � . • � , •
<br /> � �t Citp /�r c� �( Phone y�'� G� ,�'j ��i' 8nildinq Use � • • �; ';;�
<br /> � 1' .,;. . . � - , _ ..-.ri:,�.,..
<br /> •• • ` �'�� � 8tate.License Ncr�ber .�� i �.� . �D90 �scribe Work to Be Done �'�F�Y
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<br /> : . �1 L=piratioa DatB O�e �J l 7 G� ' J /�x �.�-+�?1 ��cN/V!�Ff-0 �/(,(��.� �
<br /> � '�1: • • • SICETCH PLOT PI.Ati BELOTP' • . '
<br />- . j �:� . . • .. . . , .• • Oce of Buildiri4 �-�I Y��t.
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<br /> !' j � • , � � � . ,,, � • �Hew ❑ 1lddition QRepair/Remo::el
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<br /> � i• ' ' . � • i' • ValuatSon of Construction S J j_ u �' �
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<br /> „ . .� .. _ . ' �.• . .. �. , . - '' . . PLOT PLAN P.EQUI?LE}L:7T5 . . � -
<br /> � . , , . . � . =.:
<br /> _• � • • ' . ' � • • �. • ' Zpdicate lot size, nane o: streets, �
<br /> - • ' * j:� •indicate lvcation ar.fl width oE
<br /> ' + � ' . �.' � - .. _ :: • alleys, locate proposed ar.d all � '
<br /> ' '�1 ' • cxisting baildi:qs, shc:a distances
<br /> - . i ? - :"''�- "- '! : ' . ••�i: • ' . . tp propertp lines, show distances
<br /> r� � � : � . ' _ • , betaeen buildings. .
<br /> � � ' �. . . . • : 7.ot size _ x •
<br /> � • �:.i- '. • . . • . . Lot area Sq. £t.
<br /> • r ' • . .. • ' � . Sizc of Bldq. Sa. Ft.
<br /> � � �j '� • ' ' Number of Staries
<br /> ' �� • i; ' • . • ' ' ' ' Sasement
<br /> ,'r':.� - � . . ' ' . . Signed Hy�,r"�� �1, (�/.�/j� \ '
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<br /> .� . • �� - , • . O�aner Phone
<br /> .. . DO �IOT h^.iIT� B�LO[9 TIfIS LI:7E-?OR CITY U5� OtIL'1 ' �
<br /> • Date Ceceived � � IIce Zone • '
<br /> ' Plan Cicc::_ :1urSer ' ' Pire 2one ' �
<br /> �• Valnation Occuoancy Groa�
<br /> � Pemit Fee � � Rype of Construction •
<br /> ' Plan Check Fee � Occupant Load •
<br /> , � 1bta1 Fce Due Sprinklcrs Required ' .
<br /> Datc Issucd � ' • • • • ". . � , _ .
<br /> • • • . • •�• ' • . " • . • ♦i •~ •I� . • . � •
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