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,. � : DOZLDING PERMIT APPLICATIOti � � � �'� _ <br /> . . , �� , i •a•I <br /> - , . . , . 1lpplicant To Complete This ?orm � �1�j��� •�, <br /> / <br /> . • ' Ii more than one buildinq 4s tc be cantructed, sabmit a separate nermit applica�,. <br /> . tion for each buildin3. .l separate permit Will be issued for ea�:h bui.ldinq. '�' <br /> . ' � Ovner C_'a��a � :v 3 a.�;r:�- C'i,��_/{ Buildinq Address ,'� ,j �,� � l�x; : <br /> . ' , 1lddress � 3 3.2 G�L Lot_/7-�c�T,�L elock 79i) - D��D • <br /> City �,� .f 7-r' Phone -7-. � ; <br /> . �_ Subdi4ision Plat) ,Q . <br /> _ ' • ,rchitect/Enqineez � <br /> _ • '> '.� City _� phone Hetes i Bounds (Unplatted) <br /> . i�� y /� N��ct �3r �c- <br /> • :, Contractor //O�G7iJTF!-' L �A �oy� Sec. qWp. g4e • <br /> � ' ' llddress • � . <br /> ?, City Phone Building Use ��//,/ L L.. � <br /> ����, ,. .. <br /> � �' ��� � State.License Nc.aber !��3!;// � 7�,j5 Desezibe Work to Be Done , i2FrAC,`, � � •'� <br /> ; �1 E:piration nat� ' Tn '. Ei' O i F�C' r. T o F r�L �G, <br /> � ��: � ! ' SI�TCH PLOT PLAfI BELDIJ' • - <br /> • � ! � .. ' . � r <br /> , : � IIse of Building <br /> � . . . . �Newr ❑ Ad3ition � xepair/Remo;:el <br /> . , : <br /> � . — � . • Valuatio,: o: Ccnstruction $�6,.�� 35 ' <br /> . . <br /> "".• � . � � • . ^ PI.OT PLAN REQUIREbIENTS - <br /> : � . <br /> �- .� `� �� ' IDdicate lot size, nane of streets, <br /> � : ' indicate location and �idth o: <br /> � alleys, locate oroposed a:.d all <br /> �, : ,� � - existing buildi:.gs, shc:a distances �� <br /> • � � .= � to property lines, show dis:ances <br /> + � � • between buildings. <br /> � . _ <br /> , , Lot size x <br /> ... ' � - � . . Lot area Sq. Ft. <br /> �'. •:. - . • Size of Bldg. So. Ft. <br /> . ' • Number o: Stories <br /> ' � •: � 1 • Basement <br /> •:. . - <br /> �. ':• � GI}UR� Signed Sy <br /> i <br /> ' � For <br /> - Owner Phone - <br /> � � DO :70:' iC:iZT: B=L014 THij LI:4E-FOR CITY USS O:IL'1 <br /> Date S�ceived Uce Zonc <br /> ' Plan N.zec;: ::u.:,ber ' Fira 2one - <br /> Valuatioa _ Occunancy Grou� <br /> Yeroit Fce _ Type of Construction <br /> Plan Check Fee __ Occupant Load <br /> . ; Zbtal Fee Due Sprinklers Required <br /> Date Issued ' ' <br /> . _ � <br />