Laserfiche WebLink
�. - --- -._ __ _- - -. . - - - �-- _ ._ _ _ --- _ _ ___-- ----._. . -- <br /> �r �r �ie <br /> BUILDING PERMIT APPLICATION � ���� �� `� �'y <br /> . • Applicant To Complete This ?orm ��,Ir � <br /> If more than one building is to be contructed, submit a separate permit applica- �/y/l <br /> tion for 'e/�ch building. ? separate permit will be issued for each building. <br /> Owner .'X;�p�l�i9i�� ��1�)0 f,� Building Address �S�(� � (��y� .f� <br /> Address �(�� ��f(`(�t1\�1l{'SY\ V1� . Lot ��� Block <br /> City 0��' Phone��i�j- � /����, Subdivision (Plat) `` Q`��5� cV Q."a <br /> Architect/E ineer � �'j1"��Qt.�'�'Y� \\ � <br /> City � Phone \ Metes S Bounds (Unplatted) <br /> Contractor . �q � � +��Q�_PhA Sec. 1t+p. Rge <br /> i ( <br /> Address ���� QJY l,L,� ' ' <br /> City � Q)� � Phone FZ'��j— Buildinq Use s <br /> State License Number Describe Work to Be Done ' <br /> � / � � (� �) (� \ <br /> Expiration Date (- f�� - l� � �Q p �,\ ) �N9�11,lv�, 1 <br /> • � J <br /> SKETCFS PLOT PLALI 6ELOW - <br /> Use of Buildinq � <br /> C1New ❑ Addition ❑ Repair/Remodel <br /> - ' Valuation of Construction $ N'�_�� . <br /> - • • PLOT PLAN REQUIREI�ffiNTS . <br /> Indicate lot size, name of streets, <br /> � � indicate location and width of <br /> � . alleys, locate proposed and all <br /> � existi�g buildings„sY1JW disCances <br /> , � to property lines, show distances <br /> between buildings. <br /> Lot size x <br /> � Lot area Sq. Ft. <br /> . � � Size of Bldg. Sq. Ft. I <br /> _ Number of Sto�ies <br /> "_ �� Basement � <br /> � Sigryed--S � <br /> For `�.1-c�� � ��,����o.,�,,.� � <br /> Owner Phone - � � <br /> DO NOT SVRITfi BELOl4 TEIIS LINE-FOR CITY USE O[JLY <br /> I <br /> Date .'.�ceived U_e 2one �!,�J/�!�' �.; ��svj.�f//�fol � <br /> Plan Check�yunber ��'-��J C� _ Fire Zonc #� ' ! <br /> !� <br /> Valuation ���� � Occuoancy Grouo .�. <br /> Pemit Fee _��. �v Type of Const_uction � - �-� <br /> 0 <br /> Plan Checl: Fee l�� �' � Ocr.upant Load <br /> Total Fee Due �� Sp::inklers Required � <br /> Datc Issued C�TY 0� ;-','�nF-FT � <br /> APPROVED rv:; r_�_�:�_.:;�,;e ;:.�:;;;,I,T � <br /> � C�ate '�[i/ ,.,._ `' � �. r . i <br /> _ I <br />