|
�
<br /> I
<br /> . � �i . - . � . . ` • ,• , . . . . . � . �_
<br /> __ , = Dtirt�irac r�nrir�r nrer.zcnxzo�a • � ,.•:�� ��k�
<br /> � ., ,� : � , , � �Rpplicant To CompleLc This 1'orm � ' � '�
<br /> ' • . • �'�/3��7�s
<br /> , , Zf aorc thin onc building is to bc conCructed, submit a separatc pcimit applicn-
<br /> . � ¢Son Lor cach buildin7. A separatr. pccmit will be i::.^,ued for cacli buzl.dii�g.
<br /> . � ' bmer .��.�-s�9�5Tc.E' .�t�/�.Oc,BS nuilding Address��-- f-�C1� ��,/�
<br /> , �
<br /> , ' •. , rr]dress . LoL• �F n�__�
<br /> ' , CitY ^, Phone Subdivisxon (P).�t, :
<br /> ' • Archztcct/Enryinccr �cD,4.E' cS/'OGE�L�/� � , ,
<br /> _ • _ "_i CitY Li/�`f,U/,I/G�ICLC Phon�/ :Idetes L I3ounds (UnplaLted) � .
<br /> . ;,' Cantractor � .. .
<br /> . ,.� , .,ea. 1t.q�. 12ge
<br /> ' , ;' • ' .I:ddress �/'32� lz'6�.'1�/.G�G� . . -- .
<br /> !; ,CitY ��a'OGNU/LL.�tione rPC� '"t��77 "I3ui.Idinq Use � � '
<br /> <�:a� _;�•..•-
<br /> .�'�:� � St•zLe,Licei�sc tfi:rabcr Describe F7or1; to IIe Done '��JiLG' � ���� �
<br /> u'.
<br /> : . , �i Expiration Dat� • ' �g� �� • L s=�iL�C� Gi%/T1� .
<br /> :; . . ��.- � —�� � SL � �DE -�-i FS
<br /> • ' � • sr.�z�c�i ?LOT rr�,n ��Low' �� • -
<br /> - - ••i , ' � � �?-
<br /> : ;.1 �� , ,`• �IIse oi lluildir.g • '
<br /> . . -�-�-----e--" ' —
<br /> �� : 0 . . '.' � '�:etJ ' ❑ Addition ❑ Repair/Remo�el
<br /> " � �� �,�R��- � :�.' . � : , ' � .
<br /> . ~ i' . ,��� • . � •' -5 �TaZuation of Construction $ �l�� �C''
<br /> e , �7E :� . .
<br /> -,`,• � .. / ::PSAT PLAN R:QUIRZ:'::.TS
<br /> y . . ` . , • . . . •� � 'fJ � '' �. . .
<br /> .r . . . -b 41 •
<br /> � � f ' •' '. � ' ' � �' ; C Sndicat-e lot sizc, nane af streets, �
<br /> .• ;
<br /> . �
<br /> � �O ,SUf�L �!4�"i-�. ' ' �' �indic�te locz�ion �i:d t�i.cth of
<br /> ` alleps, 'locate aropo�ec and all
<br /> .,�_i • _ , i ::. � •exicting buildings. shcsi 8:�;;�::ces . .
<br /> �;��-. �.�•e � �:,�. . ...� �
<br /> ' •� . '�• '.to property lines, �}�ow distances
<br /> •. e � ,.betwecn buiJ.di�7gs
<br /> ; . .. . .
<br /> . . . / � �C�/L .PE�i/Gc� � . ' - �
<br /> . , . / I.oi• �ize x •
<br /> - � . —
<br /> � Lot area Sq. Pt:.
<br /> �`; �:• ' • ' � � Size ef F31cg. . Sa. Ft.
<br /> , .: . , � .
<br /> Iiumbcr of SCories
<br /> ' �_: ' i. � ' . � ,���� ��� .IIasement �
<br /> e..
<br /> „ �=' . • . �(��U���� Sic�ncd BY��� ��L:-6-� --,.---_
<br /> For
<br /> ' ' � � � . � ' Utrner YLone
<br /> ' � DO :10." I':2?T$ �J:LO:'7 TlIIj LI?IE-?OR C27'X USi: Oi7L'1 ' � � .
<br /> Date S:eccived / � � U�e• Zon�
<br /> ' Plan Chec;:�:7ur.,be�• ' ' Firc Zone - '
<br /> ' Va:uation '_ ���C� �� Occuo:��tcy Group � •
<br /> Pcznit: F'cc � ZQ. ���� '�
<br /> Typc oi- Const•ruction
<br /> Plan ChecL• Pee Occupant I,o�d •
<br /> U
<br /> . � 5bta1 F'ce Due `L4- �L- _ ,pr�,�;?:lcr.� R,.quired ' � :
<br /> . ' Dzt.a T:��ucd �/��/-� �� ^ ' ' ' � : ^
<br /> --��y �---
<br /> , . . . . . ., �, �
<br /> . . .. � . _ . ;,., , ..
<br /> --��-. .���
<br />
|