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. � BUILDING PEf2MIT APPLICATION / �� �� �: -` <br /> Applicant To Complete ?'his ^orm � <br /> . If more than one building is to be contructed, submit a se�ar;ite / <br /> tion for each building. �1 separate permit wi11 be issued =or eachebuildapgl�� � <br /> �er �`�i� � Building Address ,�1pp� �n y�� ,� ��i <br /> Address Lot 'n `% � �Ij Hlor.k '�����`' �— <br /> City Phone Subdivision (Platj ��r ±�� � : <br /> Architect/Engineer � �` _ �� �' . Lj <br /> . x i'i�t. ��i i' �r ^ /� <br /> City Phone Metes s Bounds (Unplatted) <br /> i <br /> Contractor � 5a� �����,� �Sec. <br /> 7 TWP• Rge <br /> Address _r941�� � � '� `�-.� ,�,� ' . . . <br /> CitY /{1 Q.b ,Phone �if,S(�/y(7 Building Use _ �—y�,�����,� � ' <br /> State License Number �a - 571�/— /�Dy,30 Describe Work to Be Done <br /> / �Lt/ <br /> Expiration Date /(� — / -- 7 J <br /> SKETCFi PL,OT PLAN BELOW � <br /> Use of Building <br /> � ❑New ❑ Addition �Repair/Remodel <br /> � Valuation of Construction $��3 p �; <br /> . � • PLOT PLAN REQUIRE6±ENT5 _ <br /> Indicate lot size, name oi streets, � <br /> � � indi.cate location and width o: <br /> � alleys, lecate proposed and all <br /> existing buildings, .show distances <br /> � � � to property lines, show distances <br /> between buildinys. <br /> � Lot size X <br /> Lot area Sq. Ft. i <br /> ' � Size of Bldg. Sa. Ft. <br /> _� � Number of St ries � � <br /> � - Basemer.t � -� ' <br /> ( '� � <br /> Signed By � � ii • ' n:�G'�'7 '�� � <br /> � - _ . <br /> Yor <br /> . Owner Phone � <br /> DO NOT L9RI:."G 6�L0[4 THIS LINE-FOR CITY USE Oi7LY I <br /> �dYC . ^CnL';CC? <br /> U:e Zore <br /> Plzn C'.:eck ^7unber Fire Zonc - <br /> Valuation Occuoancy Groun !� <br /> Pemit Pee Type of Construction ' ! <br /> . i <br /> Plan Check Fee Occupant Load - <br /> � <br /> Total Pee Due _ Sprinklers Required � <br /> Datc Issucd C�T" ;"�'= ' - <br /> � ._� � ._,.. _,,_ r r <br /> APPROVED f0: G�!iLD": ':; ,:�;'�-1iT ,�' <br /> r,,�� '1-�- ? �f ,'=tL.C.C�v� (.�'� � <br />