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. ' - ' �: <br /> ��� �c�� <br /> APPlic�nt 'eo Cr..picte !nis :orm //e?/�� <br /> If nore th�n one building is to be ::ontructed, subnit a separate permit applica- ! <br /> tion for each building. A separnte permit will be issued for each buildinq. <br /> �- � Owner //J�p/�J%7.z�..�i� Fiuilding Addzess 3 �2`�/���_��%�_� � <br /> Tddress � �j �'� � /�,�,.,� ,r��! Lot �/ � �%'— Block ''7 � �/ <br /> City ��.,r,� :o�� Phonc Subdivision (Plat) , <br /> Wchitect/Enqineer �i/.c-er�L'� .�� � <br /> City ,Phonc Metes s Bounds (Unplatted) � <br /> � <br /> Ccntractor ��.������/ij:��, Sec. 'Rvp. Rge � <br /> , Address 5"J'''-f/ /� � / �%� .� . � <br /> City �� Phone L ��-� �� Buildinq Use �--r�;-� -.I � <br /> �� <br /> , <br /> State License Number ���-�oL/3v.�� Describe Work to Be Done _ � <br /> Expiratio❑ Date 7 -- ��—�,5 <br /> �" � <br /> . <br /> SRETCN PLOT PL7.:7 HELOIP i <br /> Use of Suilding � ' <br /> i ❑New ❑ Addition �Repair/Rer„odel <br /> ' � <br /> Valuation of Construction $�t/ Yi fi, �G'� � <br /> � <br /> . i <br /> . � PLOT PI.11N REQUIRE"SE::TS . � <br /> 7ndicate lot size, name of stre�ts, <br /> indicate location and width of <br /> alleJs, locate nroposed and .�'_1 <br /> existing buiJdinas, snow distaaces <br /> • � to property lines, show distances <br /> � between buildings. � <br /> i <br /> I.Ot S1Z0 X <br /> I � � Lot area Sa. Fc. <br /> I . Size of Bldq. Sa. Ft. <br /> ihun5er of Stories <br /> � ��£C.^..CT:t <br /> —T— <br /> s�g��a s��_�„�- � ;��„�l� <br /> , <br /> 1,'t'or ,'�r�' �1—�-,—�.__�-�' _ <br /> ' a•n�r Pnone <br /> DO NOT l4RITE BELOh7 :NIS LI:IE-FOR CITY USE O:ILY <br /> �_tc :_�:•:c' U;e Zone - -- <br /> �� ,:n C:cc;. •ic_`.,r Fire �one -- <br /> Vsluation Occuoancy Group <br /> Pcrnit Fee Type of Construction � _ <br /> Flan Checl: Fee Occupa�[ Load __ <br /> iotnl. i'c� Dce SprinF:lrre Required _______ <br /> �;<t� r.,__�_•. i ----- — - • C� ��, �,� n;ET�TT <br /> --- _ .� , ni.,,. ��,r-n• : <br /> ii <br /> . ��ty, /,a /�-� C�.�,-�. <br />