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-- -- - - _ _ ._ .. _ . . _.. . -- -- ---- _ - - --- l 9/�_ �� -'-. <br /> BUILDING PEBI-lIT APPI.ICATION ' <br /> Applicant To Complete This ^orm '���3�5/�k <br /> If more than one building is to be contructed, sutmit a separate permit applica- - <br /> tion for each building. A separate permit will be issued for each building. � <br /> C{ <br /> Owner ,L65 �UR}NS Building Address � F <br /> n <br /> Address ///� 1��h�,r3f?R a Lot slock <br /> ca�e. a� �P�=<-�-�- �79s'.E Il�y�- , <br /> City ��%G��TT Phone Subdivisio (Plat) i Sc,J /�W ��f <br /> -i� •SG �v.'4',t�c. �' �4.k. s'j�{�/.35 � <br /> Architect/Engineer �Q... E 'tA E � Q�.e-.�o (2��.fi::i 8a4; <br /> � � iao � y!. 7� 7 c�1 i o�h N. H-1•78 <br /> City Phone Metes s Bounds (Unplatted) 'f_c �pa.Mx.�j (�sg <br /> Contractor ,�l�cR�T � a�A/�-vERS Sec.� Twp.��9 Rqe � <br /> Address �"/OL� �dcRCRE�/� G�Af' " <br /> City�'YEREi T Phone ,35 3 7�G/ Building Use _ <br /> State License Number�23-o/[U-6R-E8-30/-pNDescribe Work to Be Done ' <br /> Expiration Date �` - /- 7 7 ( A�r, i `O� ��,.,. __ <br /> � � - <br /> SXETCH PLOT PL11LI BELOW <br /> Dse of Building <br /> . ❑New ❑ Addition Q Repair/Remodel <br /> . �� <br /> - � � ' Valuation of Construction $� - <br /> � � - PLOT PLAN RE4UIREbIENTS - ' <br /> Indicate lot size, name of streets, <br /> � . �indicate location and width of <br /> - � a!leys, locate proposed and all <br /> � existing buildinqs, .show distances ; <br /> ,� �� . to property lines, show distances '- <br /> . between buildings. � <br /> 7 <br /> � Lot size x '' <br /> - Lot area Sq. Ft. ' <br /> . � Size of Bldg. _ Sq. Lt. � <br /> � <br /> Number of Stories � <br /> � � � Basemer.t �, <br /> . Sign`cfc�B�j� _ , <br /> For \�� ��-�,��.ti/ � <br /> Owner Phone �, - 11 _ � <br /> DO NO'f W2ZTG IIELOIJ THZS LINE-FOR CITY USE ONLY � <br /> Datc __cei�:ed U�e Zone <br /> Plan Check VunSe- Fire Zone � <br /> Valuation ��' Occuoancy Group , <br /> Pemit Fee �� " � � � � Type of Construction � <br /> Plan Checl: Fee Occupant Load _ <br /> Total Fee Du� Sorinklers Required <br /> CITY Or ��,�r:.^�r�r <br /> �atc �ssued APPROVED FO^ L'_';!.;;''�,'�: I'� �iAI f <br /> , <br /> �� __ _.. <br /> �4. <br />