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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�.� � . <br /> �- <br /> —+e:�:_. � .. ._ ._..��_ <br />