Laserfiche WebLink
. . . . .- _ . . , . . . ..: .. ..... . . .�-,. . � -- <br />" BOILDING PEitMIT AI�PLICATION � ' ': � .� <br />_� ' ��• � • � � . 1 Applicant T.� Complete ThiS -orm �/�����'S � '�_ <br />; ' ' � • %z'f,✓ - <br />, • Sf mt�r.e than one buildinq is to be contructed, submit n separate permit a�lica= �i <br />. � tion for each building. A se�arate pezmit will be issued ior each L•uilding <br />� Q ������ `� <br />• , ��_ _�i•�•i,.�� ./)•i�h�i0sr.f',/'J $uilding Address � %,� '7 c� ��������, <br />f <br />` � 3ddress f .F/ 9 -/ri.2�nr � �— Lot BYock --- ' <br />; . <br />. . . City �/...���: Phon@;��1-�:'�.�zc�! Subdilrision (PlatJ • . <br />�Tr' <br />� ` • Architect/Engineer • • � � • ' - <br />• '+ � "'� City Phone <br />- '. �l -- . <br />_ ;,�: Contractor �r=-Z� � ' <br />_ .., . <br />�' �'• E3dress � <br />.. '� City Phone <br />.i; ,,:.. . � . , . <br />• �'�i � SWte,License t7w�*er <br />:' :.�i Ezpiration DatB <br />� ��' !! • • SRETCH PLOT ?Iv'�N BEiOW' • <br />: . I S - .. . ' .. . . . . + . . <br />� . . . . . .. <br />L' . . � <br />� � . . � _.. I .. <br />^..-- . - _ :. - ' . <br />�. . . � <br />� . . . <br />' �i . . . • . . ' ' . . .. <br />� � :��: � .. . �- �.. : . . . .� . � _ <br />. , - '� . . . , i' <br />�. r . <br />� _. <br />.�, � ;' , . • . . ' <br />' .. . 3 . . . ' . . ' ' . <br />"� <br />.. �.j r.. ', • : . ' '. . <br />r.. -: . j. � . : . . . . . <br />_ ..�- <br />•� •_. , • '. <br />�. . . , . , . <br />NOT SC2T_T� 9ELOi7 THIS : <br />Date �.^.cei.ved � Z� � •� ^ <br />� <br />Plan Check ::ur.Ser -' ' <br />. �c <br />Valuation S� -� <br />FemiL• Fee �� �� ' <br />Plan Check Fce — <br />. . � �� <br />'Sotal Pee Aue '� �— <br />Datc Issucd C 2� 7Sy <br />• •. <br />Metes s Dounds (Unplatted� <br />Sec. / S, Twp. .. � S''A/' Rge y� . . <br />� <br />Hnildin Use ' ' •''� <br />4 `. -`F_ <br />, . �'�'„ <br />Describe Work to Be.Done ��~`� <br />�� ., �-� �>i..� �o"�. .1. � ns4 G� � . <br />. . �'_ , .� „ T'- <br />se d£ B ildirig _— _� _ ' <br />�iiew ❑ Dddition Q Repair/P.emo�el <br />'Valuation o£ Constzuction $%/��� ' <br />PIAT PLIitI REQUI?2E•IE;dTS . . : <br />3'ndicate lot size, nane of streets, <br />•indiczte location and width of - <br />• alleys, locate aro?osed and all ' <br />� existing buildincs, sho:s flistanres <br />. to propertp lines, show diatances <br />between buil.dinas. • <br />Lot size x ' • <br />:I,ot a=ea � Sq. Ft. <br />. Size of Bldg. � 50. E't. <br />Number of Stories <br />Basement _ <br />Signed By <br />For <br />Owner Phonc <br />CIT'_' USE OilL'l ` <br />II�e� Zone <br />Fize 2one <br />Occunancy Grou� ^ <br />2'ypc of Construction <br />Cccupant Load <br />SprinY.lers Required <br />. . • • . <br />.. ': <br />9 <br />