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il <br /> � <br /> 1 <br /> 1 <br /> , . , � � <br /> � �OILDING PERMIT APPb2CATION • J' !� -f� • <br /> . • Tp�licant To Completc This Porm ' "�I� . <br /> ��/='l�l <br /> If mo:e than one building i,� to be constructcd , suhn�it a separ.ita per.m�.t � <br /> . .application L•or eacli building. A separal•e permit• �•�ill be is�uccl for eacli - <br /> -building. , 7 ,��. ,7� <br /> •�wner ,�^. , ` ��✓ ^ ( 73uildinq Address /� 7Z3 Ccx..�,� <br /> -7►ddress /; -;2� _{,�. � `✓J .�'� .. Lot ; 'L �i31oc): <br /> , �f <br /> City ��e�7�tl Phone °� 7S.',Cn✓�c� Subdiyision (Plat) • <br /> ylrchi�ect/�ngineer __ C��-l�ra� p�� �j» <br /> Cltj• Phone l+letes & IIounds (Unplattcd) <br /> :Cont-actor ��^�(;c�p--�,�.�.��� -Sec. 3t�rp. Rge. <br /> A�dze�s 3 /4—7,� /-JG- . S �✓ <br /> City �.�z��e:�1 Phone ���;�: 7�Ol•, • <br /> State Lice^se ldumber � <br /> 1:xpizztion Date <br /> � � . • . Building Usc y��{�rZ.r'E=. __ <br /> Describe t•:or1: to IIe Done <br /> � <br /> 'L'01PT�"'� FIAT PLAN 0'r. R.,F'V�I?SE SI� �-�",`�`�rplcG�'� �� J�"'t-•. <br /> Number of Stories <br /> � . ' . Basement <br /> - -. ' - • -• Neta Additil� Repair./Remodel� <br /> ' , • � ' • . . "Valuation of Construction $ <br /> . . , • • `�� pr, • <br /> . . _ Signed IIy �>�rr ���� .�c?C�.F� <br /> � . -'For ���r� 7�''��-�'E� <br /> � � �OM.+ner • Phone ,:i.l�< G=>�C <br /> - Do rot t•;rite IIelota ThiS Linc -I'or City Use Only � <br /> �atc Reccived Z ',�-c. �/ G' � ' � - • - � Use Sone ' � <br /> 31an C�ec1: Number - - ' • . Firc: Zone <br /> `3►aluation %C'?O� `'` � ' • 'Occupancy •Group . <br /> �Yesr„it Fee %•v .a _'Typc of Construction ' <br /> 3'lan Clieck Fee ' • -accupant I.oad <br /> �btal Pee llue �rinJcicrs Required <br /> Datc Issued - _ • <br /> , - _ - � _ . - <br />