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--- -- - - - - �l; <br />HUZLDI?4G PERMIT APPLLCATION `J "'� <br />/ � / � <br />� � Applicant To Complete T.his ^orm /o2�j �� <br />� If more than one builning is to be contructed, submi' a separate permit applica- <br />tion for each building. A separati: permit :+ill be i=_'ued for eacli 5ui7d�i,/r�g. <br />Otmer � lvNl �� �,�{���� Building Address ����� �� �ti��������E� <br />Address �� � t�! ��C Lot �� �� Block <br />n�� ���-:.�I�( � subd'vision (Plat) <br />City � � �° � �'� Phane � `� � <br />Architect/Engineer ` � <br />City — Phone _ <br />Ccatractor <br />. _...-- �— �----- <br />���� �� "� � �l %���� — <br />Metes 6 Bounds (Unplatte ) <br />Sec. 'LWp. Rge <br />address ' ---- - I <br />City --- Phone Building Use }-�� U 1 IJ � ( � (� <br />Descri'he Work to Be Done �,� ���'�/1 <br />State Licease Nmnber _ � <br />Expir�.tion Date <br />��I(��� /'i�1(��Fti (�fu���G�'�'� <br />� r <br />SRETCA PLOT PLF1V BEiOW <br />� <br />Ose of Building <br />❑New ❑ Addition /�.`�epair/Remodel <br />Valuation of construction $� G��%� � <br />PIAT PLAN REQUIRE61ENT5 <br />Indicate lot size, name of streets, <br />indicatc location and caidth of <br />alleys, locate proposed and all <br />existing buildinqs, show distances <br />to property lines, show distances <br />between buildings. <br />Lot size X <br />Lot area Sq. Ft. <br />Size of Bldg. _ Sq. Ft. <br />Number of Stor�es <br />Basercr.t � ^ <br />�� � <br />Signed By '�1 i� 4C. �� �'(A(.�20 <br />/ <br />For I _ - <br />Ownet Phone 4-� -� �`� � <br />DO NOT WRITS BELOI9 THIS LI:Ic-FOR CITY USE O:ILY <br />��,� ...._„_:�? _ J_e 2one - — <br />?1_n �..ec% `Iur`er <br />Valuation <br />Pemit Fee __ <br />Plan Checl: Fee _ <br />Total Fee Du� _ <br />Datc Issucd _ <br />Fire Zone <br />Occuoancy Group _ <br />Type of Construction <br />Occupant.Load <br />Sprinklers Required <br />