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<br /> �� ' �� ' ' SDZLDItIC PERHIT TPPLICATION � � � ' • ' • / ��?��e �
<br /> ' .: 7 . . . ,. , ..• . .•
<br /> , , Applicant To Completc This :orm ' '
<br /> .. . ; . �. .� :,��g��/s
<br /> , • • � Zt rarc th�n onc buildinq is to bc contructed, submit a �eparate pernit applica-
<br /> _ • � tica for cach 6uildin3. .1 separatc permit:will bc issucd for each building.
<br /> . � � � 6mer �/.L /=�'b�r ���,vilSuildinq Addrese SO;�i Evc.e 4Rzei� :iUA�(�
<br /> , � . . � llddress �aiG E�c.t r^ o . _—'—v /
<br /> ,tc� .✓ t_li.ay Loti7,i£rir. .��?.1/ BlOck
<br /> ' , � City �vcR�TT Phonc Sub3ivi (Plat) � � � �����
<br /> ' = Erchitect/Engincer
<br /> C?��e i T�.�iY -�,..tre.-4 % .f�. .
<br /> '_ "_'j City Phone Hetes & IIounds (Unplatted) ' .
<br /> �.'. Cantractor L�iNt; - i`lr. I' eaue/v /%.�4etl. 1t,�p. Rq� , ..
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<br /> � ' ' ' . �L'3zess ��i ✓t'�.c%'c ft //�C il . . . .
<br /> .. 1'; ,CitY �uL2.eTT Phone ?.S�i'-���� 'fluilding Use k� �i..�/f� �._a :., ' .
<br /> - �yJ � Sttte.License f:i..-�aber �2z�- a/-/� �7/ Describe Work to Be .Done ,rj,���,�,�+�ti„J''�
<br /> ; :� 'I �iration Dat� ( _. S — i G — ' �
<br /> ���, ��ti �'c�C��L ��'�
<br /> � �>: �" - �S�.ETCIT PLOT PL7.!7 BELOT4' - �.-J✓ •_^� ry(.lrT�� ' -
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<br /> . • _ 1 •.. ��c�. t'<-1.e'i..r,cti:,.�,,� 'ilce of. :iuildir.g �1��_ '
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<br /> �-���1�`_ . . ; ` ntdec� ❑ Addi.tS.on � I;epair/?:emc;:el
<br /> !' - � • • . � � 'Valuation of Const=uction $,;(U'o o.� ' .
<br /> . • . . _ .
<br /> �. .. , . .. . � � . , �,PIAT P7.I�N R-'_QUIrE?'::ITS .
<br /> ' i � ' Indicate lo� si.ze m ,
<br /> . .• ,� , . . ' � . • , na..� of s:rect�
<br /> , s , ._ . ' " •indicate locat:oa ar.d :ridrh o:
<br /> ' ' ' • • • alleys, •loc�te aroposed and all
<br /> . :-'� - . . �
<br /> ' � ' - • ' � � •exi��_ing buildi:gs, sno:v di�taaces
<br /> _ • - - . .a .
<br /> - •; . "� ' ' . . ' = . . -io property lines, �ho;a distar.ces
<br /> � '• ; -e • . " . _.bett:ecn builciags.
<br /> . , . � . � . � � . • ' . ;S,ot size x .
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<br /> � • I�L- area Sq: Ft.
<br /> �•; •:. - . • � Sizc oP F�lc9• Sa. Ft_
<br /> ' . ' , ' • Rumbcr of S;:ories
<br /> ' ': ' �. • ' IIasenent
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<br /> ��• � ' ' ' � Signed �JY /I C-r�e-e� —�i..%Je, �'� '�!�• f rr�-a..
<br /> 3' . ' . • ' For� • •
<br /> , . Owncr�hon �� -� o 0
<br /> . � DO VO':' S•:2?1'S 9ELOS'7 THIS I.I2Ii-FOR C:'1`Y DSr O[iL7 ' '
<br /> : , Datc �eccived �'/ I Q �'7 S_ U�e Zone
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<br /> ' Plan C:�cc:; `;ur..bcr _"7 ,�`j -�jSZ ' Firc Zonc Z•
<br /> .��aluzoion ' 2� �� _ Occuoancy Crou� Fr - i
<br /> FGn�t F�� �ZC�- �
<br /> , 1'ype of Construction �,
<br /> Plan Chcecl; B'�c • OccuPinC I.oad
<br /> . � li��ta). Pcc ❑uc � �i—� '� �� ��rinl;lcz•� P��qiQ6�i�f10F EVFRFTT �
<br /> ra:c Tscucd ��/(U�- ✓ • . APPROVED,FOR BUILDING PERMIT .
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<br /> . .. . . : Da(e�_I�3. l By ;/��- __�„ .
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