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HUILDING PERMIT APPLICATION / � / ��� <br />Applicant To Complete This ^orm !/ <br />If more than one building i to be contructed, submit a separate permit app� ca�� <br />. tion for each huildinq. separat •permit :uill be issued f�r eacli buil.ding. <br />r (� <br />Owner ' � _ i %'> �.x % � Buildin Address ' �''"����if° <br />4 � �,� Cr •. /.. ; '.u/ <br />�, � /L � �1 / <br />Address � �� !/, � .:' � /�1 y-r c�Lf Lot � (� Block � <br />�r � � <br />City ,it �' ' Phon� �' � ? c�,f ' C�� Subdivision (Plat) �f� ;,1�/� / j //��'� <br />� " � <br />Architect/Engineer <br />�//% � / <br />City Phone Metes S Bounds (Unplatted) <br />Contractor <br />Address <br />City <br />State License Number <br />Exp�ration Date _ <br />Phone <br />SRETCH PLOT PL11N BELOW <br />Sec. 'LWp. _ Rge <br />Building Use D . <br />D05CiYb+� T9C';: •,� Ri' <br />/� � . v - <br />Use of Building <br />� f , � �� <br />r'�� ta /_''.!'.;(' <br />i <br />�n� " . <br />�/.c/��� <br />.i.TilA.. % 1 . <br />❑ New ❑ Addition �Repair/Remodel <br />Valuation of Construction $ SQ�'dC'% <br />PLOT PLAN REQUIREtdENTS <br />Indicate 1ot size, name of streets, <br />indicate location and cai.dth of <br />alleys, locate proposed and a11 <br />existing buildinqs, show distances <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size of B1dg. Sq. Ft. <br />Number of Stories <br />9ase^er.t <br />Signed By �. )iZf F. , /1�'_._. <br />Pcr _ <br />ner Phone <br />DO NOT WRITB 6EL0[4 TF[IS LP.7B-FOR CITY USE 0.7LY <br />73tC ..,.Cn_5-C•' _ ULE Zone _ <br />PLan C :ec% `turi•e� <br />Valuation <br />Pemit Fee <br />Plan Checl: Fee <br />Total Fee Due <br />Datc Issucd <br />Fire 2one <br />Occuoancy Group _ <br />Type of Construction <br />Occup�nt,Load <br />Sprinklers Required <br />n <br />