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I M BUILDING PERMIT APPLICATION <br />Applicant To Complete This Form44 /-/•/ 7 <br />If more than one building is to be contructed, submit a separate permit apj is 7� <br />Lion for each building. A separate permit will be issued for each building. <br />Owner LU-rly@2 CgkL CEIA TEI� n <br />D Building Address <br />Address d c-t• r Lot Block <br />City EVE M7T Phone 25.8- 4 52 1 Subdivision (Plat) <br />Architect/Engineer CMS (no(Lqu 4 A5;0e-S <br />( City EUE(LETT Phone 357 - 2388 Metes S Bounds (Unplatted) <br />Contractor ELLW6 "ALuoa_SoN Sec. Twp• Rge <br />Address (nos S, RH1E1-Sipe ve, <br />City 5E1477LE Phone W7-718S Building Use CRILO(&Af RertOB4el <br />State License Number 223- OI - 1394 Describe Work to Be Done CoNfi,R.VGT <br />%-/-7S <br />,f Expiration Date 2 I16W CNII.Ooa� u.5 (Zartoew-a 4IL06't <br />SKETCH PLOT PLAN BELOW' AKO I UTILITY d STG Bu96 <br />,Use of Building RIXIOtW <br />OAL- <br />IL <br />new, ❑ Addition Q Repair/Remociel <br />Valuation of Construction $ 300,000�' <br />"�• • - PLAT PLAN REQUIREMENTS <br />y <br />I Indicate lot size, name of streets, <br />1 indicate location and width cf <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 />r.. Size of Bldg. Sq. Ft - <br />Number of Stories <br />Basement <br />. ; Signed By <br />For <br />Owner Phone <br />DO NOT W:2ITE BELOW THIS LINE -FOR CITY USE ONLY <br />— Date received S 8 ZS Uce Zone <br />7' Plan.Check Number Fire Zone <br />1 Valuation rccupency Group <br />remit Fee Type of Construction <br />Plan Check Fee Occupant Load <br />Total Fee Due Sprinklers Required <br />Date Issued . <br />