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— • , .. � . ' , ' _ SOILDItlG PERMIT APPLICATION ��,./�`��',:a'Y �~ .�..i ---
<br /> � 1lnplicant To CompleCe Ttiis =orm / ,i
<br /> _ . + . • • . /��/Gl7S'. .
<br /> , • ' Y! aore than one buildinq is to be contructed, submit s separate permit applica- •
<br /> . . tlon f�r each buildin3. A separate permit will be issued for each building.
<br /> ,n �% � q -
<br /> . • Ouner Ft•. ; �•r-: � IIuildinq Addzess � 2 � a � �rr.�:�"��`��
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<br /> S . ' . � �LCSS �.. � c� � ?..-�._..A�+. , .� � 7Ati L.i�)- � HIGCIC �I�7 � f�—/�lD .
<br /> City �._.os o�/� Phone Subdi4ision (P1at) �% L _F. � F� • , �
<br /> ' - Bschitect/Enqineer • • • ' •
<br /> •� � "� City • Phone Fietes i Bounds (Unplatted) ' •
<br /> ' �:.� . � I _L� ��/ . . _
<br /> - :.'. Contractor T�_;r... ..E4 i �.C�1_-l�%Q'J Sec. _ 1tap, gge .
<br /> = .;' . '• 14ddress �� Z,/ �f T�i �.''��•.2lzti/oiU..e�C/ . . . ,
<br /> . j
<br /> . .'f City � ,� � * . Phone �l�)�:�tfti ' Dnildin Use '� , Q � (�':.:e.. _= .
<br /> 6 s � ���.,_�,� �� a =:,-
<br /> � �'�;� � State,License Nuiaber �,c� Describe Wozk to Be Done �n,n,.t,r..,.c.:•,• ��''
<br /> - � r . � � . . /j, . : .
<br /> : . :i E?piration DatE � � ,r,, ' n ,��% rs ..� ) l �
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<br /> - ��' � • SRETCH PLOT PI.�N BELOW' • .
<br /> � _: '. � �. " • . � . � Ose of Buildirig ' .
<br /> . . ,' . , . :
<br /> a• • , � � . ,,. " �New ❑ Addition �Repair/Remo�el
<br /> . . `.i � . . � � . ' iJ � . .
<br /> �. " .` , . �• - Baluation of Construction S � � o,o�d
<br /> � '• . . . -. .. • . .. . I . -
<br /> ...,. � . � �• � - .: .�.• -., � _ ^ . PLOT PI11N REQUI_Ti&`IENTS . _ ' .
<br /> _' , � . . . ' • ' I � . . . . Y
<br /> ' � • • � ' • � � • • . • ' Zpdicate lot size, na-ie of stzeets�, � �
<br /> � + � ' . ' _ - •indicate location an� width of �
<br /> - , � ' • ; +: � ' - .. _ • allcys, locate pronosed ar.d all
<br /> . • �-'t ' � • � � existing bnildi:qs, sho:v distances
<br /> . ; *� . .�:�-�- .- x • � • . .�'. • . . to proper.y lines, show distances
<br /> V % � � ' � - between buildings: .
<br /> e. � - � a _ _ , • . ,
<br /> . ; . , .. . .. . ' . . , - ' Lot size x ' . '
<br /> - :• ' , ,. . .
<br /> ' • _ . ' • . • ' .' - , . Y.ot azea ' Sq. Ft.
<br /> . .• . �. _ . i:. . . . • Size of Bldg. Sa. Ft.
<br /> ' ' �'i , '. . • • Number of Stories
<br /> • :: . � � . _ • ' Basement •
<br /> .'r,.� _ . • Signed By :�-, - �f .��
<br /> . ;.' .. . . . . .' . -.. � ' T?or
<br /> • _ . . Qwncr Phone
<br /> � � .. . DO :10; S•:ZT_TE D�LOF7 T}iZ5 LI:iE-POR CITY US OiIL'1 � .
<br /> . Date ��ceived � II�e• Zone . �
<br /> ' Plan Caec;; :7ur,ber ' ' F:re 2one '
<br /> • Yaluation Occuoancy Grom �_
<br /> Petnit I'ee � ' Type of Construction �
<br /> Plan Check Fee � ' Occupant Load •
<br /> , � Total Pee Due Sprinklers Required '
<br /> .. ' Datc Issucd ' • ' • ' ' , ' ' . . , . .
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