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<br />• � ' " ' ' � DDILDI[4C PERMIT APPLIC.nT.LOt1 . � , � � ' �� , � /�•,� � /�.',�� j
<br />� ' � � �.Appll.c�nt To ComplaL•e Tliis �orm , ' •. ,,'�,/��%,y,;! ' '
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<br />,. ••� Sf taorc than onc buildinq is to bc contructed, submit a s'eparatc permit applica- •
<br />•. tion for each buildin7. A separate permit will bu issued for each bui].�ling. ,
<br />. � . �� ��
<br />. �' O�mer k�'y�,, Buildinq nddress c��� �'� , 1 I h(ii �7t�
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<br />. . Eddress ; � ' , Lot (., V '7 ' B�.ock �� � 1.-I - CX�
<br />•' s. City�\YP�_`�" Phone�3��-.�/./9 Subdivision (Plat) C/�U1,�C%� ll�e >�.(� ���,p .
<br />'' ' � drehitect/T'ngittcr.= � + ���7(�n' ' ' '
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<br />_ • _'_ '.'_y City \� • Phone ` .Metes a 13ounds (Unplat-ted) _ •
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<br />. � . �.,', Contractor � � ' � ,� � . Sec. 2wj�. Rqe �
<br />� J ..' liddress �}�' 9 � � • :
<br />• � � - . ' .
<br />•' ,CityCsl-Q�10'��' Phone. �7 -, .`8uilding Use ' ' `•,; C;;; �
<br />��'�� � Stzte.License ti�ber (]�����/—//y1� Describe SPork to Be Done .����,,
<br />: . �I E?Piration Datt: CV - G � �l `,L_ ' •L�9`$ v� ii �r�r� i �1n QQ� �.Y ��L L�_r� , •
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<br />�� : ' .. St.ETCIi PLOT PLn"i BELOf•7 � • \ `�l'-�1� �-Ct�l u'��.
<br />... ..� • �• ' ' • �
<br />. ', � � " � � ` IIse of i;uildir.g '
<br />'�. :A . .. . _• . . . ,. .
<br />_a• ' ' ." • . , : j]hcw ❑ Addition [�}Repair/Rc•mo�el
<br />',. . . �.' . . . i' . , . .
<br />�i� � " - 4aluation of Censtruction $� Q� �
<br />• � . . • • • � .
<br />.-,,.- � '- ' .. � . . - . . ::PYAT PL2�12V ILC?UI?2L':27TS . . �.
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<br />" 9 • • � ; • � •. � Indic7te lot szze, nane oi streets,
<br />'. ' '� • - � • . " � ri.ndicate location ar.d cvidth of .
<br />• .••i " - � • • alleys, 'locate arouosed ar.d all
<br />• �-'j � ' � ' � .exicting buildir.gs, shc:�r di�tar.ces
<br />;?` - .. -. - - �a : � _ . . -.to property lines, si�ow distances
<br />.� � .
<br />; , • ..q . - between buildings.
<br />; - , .
<br />t. . .• . ' I.ot size X .
<br />• . ... ' . , • . iot area Sq. Ft.
<br />... S , • . . 'Si�e of Bldg. ' Sq. Ft_
<br />�; ' • • I7uL�bcr of Siorir_s
<br />. ' :; . j � � , , - � ' . .Base:nent �
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<br />�� ; � .' ' � �_ . . . gIIC�c` j� .�" . .. . .
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<br />. . • FOT� � R).n ��1��-�.1...J---�
<br />, , .' . • . � Chaner Phona � � .
<br />.. ' -" � - � DO NOT fiZT_T� 9:LOF7 �THIS LI.Ii�.-POR rT7'Y US:: OiiL'1' . . , �
<br />Date `:eccived � U�e 7.on�
<br />' P]an Chec1: t7ur..ber � ' Eirc Zone 3 " ,_�
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<br />Yaluation �%' ��)GY�, �- Occun�ncy Grou� j
<br />Pcmiti Pcc �T��� ` � 't'ypc oE Construction �1 - �P .
<br />Plan Cliccl: 1'cc �• OccuPanL Load .
<br />, iVtal F'cc Dur i. �.9prin�:li.r� R�.q�i�r�t�lo��.� � , :
<br />' • •APPRbVED f:Of2 6UILDING PERMI.T
<br />D:.tc .l'�cucd . . •
<br />• • , . . ' . , . � D;�te•'' ; i •1-i�''i' � � By �. C . .
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