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- - / '�` �. <br /> BUILDING PERMIT APPLICATION '� � <br /> Applicant To :.omplete T_his ^orm ��a`/75l <br /> ip more than one building <br /> is to be contructed, submit a separate permit applica- � <br /> tion for each 6uilding. �� separate permit •.�ill be issued for each building. ` <br /> � Building Address �7 Q G% �U ��i l'n�<< <br /> � Oamer ����/rU �l .� l�or��// d <br /> / // � �Z Block �Z O /� � �'cu <br /> Address ��"U ��r'�i �`� n Lot / Z c ----- <br /> Phone � �� - ���y Su2xtivision (Plat) ���� r'� n� � �— <br /> city /�'l�� >t,� //� ._— <br /> Architect/Engineer _ <br /> City <br /> Phone ____ Metes 6 :,ounds (Unplattedl <br /> � Sec. Twp• Rge <br /> Contractor /�'��' ' • <br /> Address • ��-' `' �/ � / <br /> City <br /> Phone Building Use !( r'� ? �� / <br /> State License Niunber Describe Work to Be Done �_ <br /> Expiration Date �. <br /> SRETCH PLOT PLA:1 BE�Ot� • <br /> Use of Building <br /> � � G�� C,r �� � �//-/ �/ ❑New ❑ Addition '� �epair/Remodel <br /> /�� � r� Valuation of Construction $ . C�� 00 � �� U <br /> �� E �r= r <br /> //( S'�d . , :. PIAT PLAN RE4UIREb1E:1TS • <br /> Indicate lot size, name of streets, <br /> � � (�� �� �L � indicate location and caidth of <br /> � � � / <br /> �� � , alleys, locate proposed and a11 <br /> existing buildinqs, show distances <br /> � ���� �j /Qy . tp property lines, show distances <br /> %��y� c/ ' � . between buildings. <br /> Lot size X <br /> • Lot area Sq. Ft. � <br /> Ft. <br /> Size of Bldg• �--- 5q' � <br /> � Number of Stories � <br /> � �� 9ase.^..er.t — ' <br /> �— � i <br /> ' �j�/ �, l .l�i d.�l c� i <br /> S1�j1Gd �Y t <br /> cor �. — ?, ��_ 6�`% I. <br /> � <br /> Owner: Phone <br /> �_�� � <br /> DO NOT {JRITG 35L0['] THIS LI:IE-=0R CITY USE O:ILY �, <br /> � U-e Zone � — <br /> ��tc . -___. _ . <br /> , 7n y..^`,r ` Fire Zone - <br /> u^`�r <br /> Occuoancy Group � <br /> Valuation <br /> Type of Construction <br /> Pemit Fee <br /> Occupant.Load i <br /> Plan Checl: Fee � <br /> Sprinklers Required <br /> Total Fee �ae ' ' <br /> Datc _»ue1 � <br />