Laserfiche WebLink
BUILDING PERMIT APPLZCATION <br />Applicant To Complete This ^orm <br />/ � �:.a � <br />If more than one building is to be contructed, submit a separate permit applica-f/ /3�r <br />tion for each bui�'�ng. A s�eparate permit will be issued for each building. <br />Owner �✓/� �ilN �dI^/ S� Building Address �.�4-�^U �/.�f% / <br />v <br />Address �,S�Sq_ �)/�,��//�'�i� r.o+:�_ aio�x �c�r/ �i��J � � <br />City �'(/eriiF�f� Phone ,35,5 ��+.�� Subdivision (Pl.at) � <br />Architect/Engineer _, <br />City Phone <br />Contractor � l�//(/.�`"i r� <br />Address <br />Ci�y _ <br />State License Number <br />Expiration Date <br />E <br />Metes & Bounds (UnplatL-ed) <br />Sec._`_ Tc+'p. Rge <br />a <br />Phone Building Use ''/ �/�rZ I��rS'rv <br />Describe Work to Be Done <br />. r /5�.�// ��o �Oa��i �.r�.0 s <br />� <br />a <br />SKETCH PLOT PLAN BELOIv <br />Ose of Suilding T�! 1%��` � � <br />� ❑ New ❑ Addition L�iRepair/Remodel <br />" Valuation of Construction S �� � <br />• • PLOT PLAN f2EQU2REbffiNTS <br />Indicate lot size, name o£ streets, <br />indicate location and width of <br />alleys, locate proposed and all <br />existing buildings,.show distances <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size ot 87dn. Sq. Ft. <br />Number of Sto�ies <br />Basement <br />Signed By ' /'/ <br />-"l_ <br />For <br />Owner Phone <br />DO NOT SVRITE IIELOW THIS LINE-FOR CITY USE Ot7LY <br />Dzte ".�ceivec U�e 2one <br />Plan Chec}: Number <br />Valuation <br />Pexnit Fee <br />Plan Checl: Fee <br />Total Fee Due <br />Datc ?ssued <br />Fire Zone <br />Occunancy Group _ <br />Type of Construction <br />Occupant Load . <br />Sprinklers Recu=red <br />�(12°'1`� C�Z ��'�Z ��F— <br />\ <br />