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� � � ' ' }3U7L�II1C PI:RI•tIT 11PPL7C11T20[1 � � � �7' Y �
<br /> . _. ' i . . , ; �
<br /> ' „ . � . . �PPlicant To Co:npleL-c 'fliis i'orm � f/�% ��3 y���':.r
<br /> • • ' Zf t�re thin onc 6uild'znq i� to bc wnirur.t•ed, ,ubmi.t a 'c lratc �/��,5�
<br /> � , iion £or cacli buildi». . A c �race =' p' Pcrmit• applica-
<br /> , 7 � p< permit will bc i::sucd lcor each buil.si.ng. ,
<br /> . � ' 0'.+ner 9,[D'/,�/Q,g,�j ��OpP/NG f3'q�� Bvilding Addres� %0.3�0/ t'VF252�nr w,�V
<br /> �
<br /> , � . . Lldress zwoqsi,vv.e,p#6o � Lot • nlocx '
<br /> � ' � CSty fyE,e6r� Phone � Subdivision (Plat) . -
<br /> _ ' • rschxtcct/Enginecr � •
<br /> , ,, ' _.I Cik.
<br /> _ _ •=� Y ,______�_Phone Fi�•tes L I3ou»ds (UnplaCted)
<br /> :.� .. , �
<br /> : ' .;�•. Ccmtractor �AMf ��. [�A:lr,2 .^,ec.�Q Torp. '� -� xtge Q ¢. . ..
<br /> �. .._ .r.3ar..,s , saM� 2 _�� . — . . :
<br /> - !; -.Gity �6,eLT,-- .Yhone 'i3ui.lding Dse iep1P. OF�id� .��",-' .
<br /> . •:,i . . ---
<br /> .r'-' . .
<br /> ' `,•� � State.I.icense 27i:r.iber ZZj-�/ -/]�7 Describe Hork to He .Dnne- �`�����'��
<br /> : �• .i 7:xPi=ation DatB . . ' .
<br /> • �� ' � � -� SP.ETCH PLOT PLiv�I B1iL0I•7' • -
<br /> _ .+ •
<br /> - � , .
<br /> . :.1 �. ��/, . • .IIse oE nuildir.g . � •
<br /> ' . ��•. .. .
<br /> -L• • = , . �Rew ❑ riddition ❑ Repair/Remo�el
<br /> '. . . ' •. -
<br /> • .!' - � •� � . _ • • Feluation of Const-�uction $ ,zODO � "
<br /> o .
<br /> � —r—_
<br /> _,,,,-:.• .. -. . - :�;PUJT PL21I� RSQUIFiL`�:;?:TS
<br /> � , �. . , . . . �• . � . . : .
<br /> • ? � � '�j� • ' �: Sndicate lot size, nane af streets,
<br /> � � ri.ndicatc location zr.d o;idth o�
<br /> � , ;:�� - . . ' •>� f ' • al].e��s, 'locatc ar.oposed a;.d all .
<br /> =1 � . ...- - ' . �L: . . • .er.isting buildings shoo: di�;;ances '
<br /> '.�° ''= -.io pr.operty ].ines, �sno�a distances
<br /> .: . .� ' : , • . .
<br /> - ' � � -a � � ' between builriings. .
<br /> � ' .�\, . _ . . .
<br /> • t . `_ .� � '�� �� �A . :o • Lot size ,700� x 8Oo � _
<br /> qj `����0� liot area �,/ AC s Sq. Ft.
<br /> . � . �.- �y °r� +' � � , 'Size oi �Slcg. _�� Sa. Ft.
<br /> ' • ly Q�� 4�,' � ItuLnUer of tiLoLics _ QNf_ �
<br /> �.. __`- � : '¢� �. ' Basement ` .VD--F-
<br /> �` -� . . � . . .Signcd� Bi' �l'1lL1 1.4.�lhAMY Ylra� ✓�l.i .l
<br /> ' , ' . � • � Tor =�-AM� 7�3-/OBD '
<br /> ' . ' Oc:ncr Pl�une '
<br /> . : .. DO :dOT Sti:i?f 95L0!7 �.1lZi LI.U?-POR rT7')' U5': 027I,'1 � � �
<br /> ; _ Date `:eceived. __��j"_`7�� t�--- Uce� 7.on� ��^'��-�y2�..L �-C3�7M�L � .
<br /> ' Plan C:iccl; ::ur.,bcr i S-3¢7 ___' Pirc zoae �� - '
<br /> Valuation ' 2000. �� ' ' �
<br /> , , • _ O:r.;innncy Grou�
<br /> Ycrniti Fce 2Q, �" •py}��c o£ ConsL-ivci:ian "
<br /> Plen Cl�ed; T'cc � • Occup:ent I.oad
<br /> . . ��! M17�'J . � . . — .
<br /> . ,^atal F'ce llue _ � . Sprin);l.cra R��quired ' �
<br /> • . D:te 7s.^.ucd ..����Sr . e . . ' : . . - .
<br /> • _ .. • , r�.� � .
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<br /> —+e:�:_. � .. ._ ._..��_
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