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BUILL"KG PERMIT APPLICATION <br /> Applicant To Complete This Form % �� �j/ <br /> . / <br /> - If more than one building is to bz constructed, submit a separate permit � � <br /> • applicatiun for each building. A separate pe:mit will be issued for each J a -�j,s <br /> building. <br /> � / "7 l � <br /> Owne� %��i �i1Q�� � �0 �J Buil.ding Address/�(�CJ ��(�.�'�.- � <br /> I�\ ���Q ri 1 �..+ 1 v I � �J <br /> Address � � .1� Lot, W-._ � Block �JC� <br /> r� r t'� � <br /> Cit��l`,SL. ��_PhonCX__}�ut�division (Plat � i�. �.C.,. „�`"` l_�1��.: h���'. <br /> Architect/Engineer' � _ <br /> City --� Phone t Metes & Bounds (Unplatted) __ <br /> l � n <br /> Contracto�l �" C.IX��C1 ;Sec.__T�vp._Range <br /> Addres�s r , ��. �� ��_ <br /> City`, ��=�--Phone��� 33uilding Use <br /> . i � �����.}.. <br /> State License Numbe�2"�II�O�,��C2scribe Nurk to be Done�y-it� ( ��, <br /> . Er.pira[ion Date �= � Y�_ -� \��� 'h � �����A�'l '`�� <br /> � ) <br /> SKETCH PLOT PLAN Bl"LO�V � <br /> . Use of Building _ <br /> .Q New L] Addition f�Repair!Remodel <br /> - Valuation of Construction $ � �'S(�n_aO <br /> PLOT PLAN REQUIRENf�NTS <br /> � Indicate lo� size, name of streets, <br /> indicate location and �vidth of alleys, <br /> � locate proposed and all existing <br /> buildings, show distances to prop- <br /> � erty lines, show distances betu-ear. <br /> buildings. <br /> Lot size x <br /> ' • Lot area Sq. Ft. <br /> �" Siac �f Bldg, Sq. Ft. <br /> Number of sto:ies <br /> I3asement _ <br /> Signed By -�., � Date � <br /> � <br /> For 1 ���.��- � .. � __ . <br /> Owncr hone <br /> DO NOT �4RITE BELO�V THIS LINE - FOR CITY US� ONLY <br /> � Date Received �% 2-`-� �J iJse Zone _ <br /> Plan Check Number Fire Zone _ <br /> / C_. <br /> Valuation � �lD�-� ' �— Occupancy Group_ _ <br /> C �� . <br /> Permit Fee � C- � __ T�rpe of Constructiun <br /> � Plan Gheck Fee _ Occupant Load _ <br /> c�<% <br /> Total Fee Due � ����- SprinY.lers Required _ <br /> Date Issucd __ . <br /> � 7 �X�j�REq' ' � � <br /> • ` �,����' fi4�'��� ,^ r.. ' <br /> i � , i � <br /> . • • <br /> ' ._�. ,. ��_ .. � .. <br /> :. , � . . . " on -- — - - � - -r' , . . <br />