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<br /> � � � ' ' ' IIOILDII7G PERbII'' Ai'PLICATION � � ' � -� /- '•'T �
<br /> - � :� ' " , , � f�pplicant To ComplcCc This :'orm . � . / C� �.OL••:I
<br /> .. . . . �� �. ' /. _
<br /> ; • ��y , j
<br /> • • 2P lwrc th�n onc bui7.ding i� to bc contructcd, submit n c aratc //" �
<br /> ^ P pcir,�it �pplica-
<br /> . , tion for c�ch buildir.3. A separatc permit will bc issucd f:or cach Lui).ui.ir.j.
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<br /> . � � 6mer ��1� i°!, � �l _% / �.• "')� ;��' � 0 1� Builling Address �
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<br /> . � � � Pddresa _ J�"J�f�. ri_ J (- i � � � � 'Lot• �::;' ��J i ' , Dlock `�:"'� .
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<br /> . City r r �s:r� , � 0 _ Phoue"„�i��- ��''>J/ Sub3ivision (Plat) �ti�t_L'�On�_i / S r •
<br /> _ � ' • Pschihcrt��nginecr � . �,/�j° .�� ��•� � 1-^. � �
<br /> � � , � , � .
<br /> _ _� `:� City � Phone `� .I•:�tes L L'ounds (Unplatted) � . l�
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<br /> . ;,� Contractor �� ' ' 1 t;_l i 1�?I ���J i i_. ', � .^,ec. 1trp, R9� � �
<br /> . . .,
<br /> �dress :�-(';t,, ��C9'�i?C�hUG � t��a � ' � :
<br /> . �� � . �
<br /> � . ' -.City��� l 10 `� 0 �� .Phone ,
<br /> �>>`��Yj,f�,_(, 'I3ui.Iding Use �,� <' _ , - '
<br /> � ��;� � Stzte I,icense it�,..ber �����-('.��/�>C:� Describe Ftork to IIe Done ������
<br /> � : � � i L'ipzration Dat� �,{- � �l � � � � `� (`,',� C� .1� �'���Y'n:�� �� ��� �i' t� -', �
<br /> ._l. : . .' " ' � �` r � �-i
<br /> . . • srs;i�c�t rt;o,^ rr..,�r s�Low' • -
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<br /> • �- i �� . D�e of. Buildir.g • •
<br /> � . . . � . � . —
<br /> °� � • • � � , � : ' � �Idec�t [] bddition (�hcpair/Remo�cl ',
<br /> • � i' _ � � � - • . - •C*aluation of Construction $ c��`��('i ����
<br /> o ' . . � ' _ . .� . . . .
<br /> �.. - ' . � nu�r r�.*�a r��ui^�:::;:zs
<br /> :.^ . � ' � • , . • . � - ,
<br /> . - . ' � � � . . ' - ' � • ' � - 2ndicate lot size, narae of . rcet.^.,
<br /> � � ' � ' ' � � ' � � �indicatc loration -ar.d �:ict`�^o�
<br /> ' •"� ' _ �� � �- � � ' allcys, 'locatc pr000�ud �.::d a'_1 �
<br /> .. � , '� . . ' .er.isti.ng :�uildi.^.cs, shc:�� dirta;::.•es '
<br /> • �� ��• � �' b . � . - = � • . � .t:o propr_rty lines, si-;ow distancc�
<br /> � o • . ' . _ .bettacen. builtiinqs. � '
<br /> � � . -. '
<br /> : t . . . ' _ Z.ot size x -
<br /> • - . . — I
<br /> � .. . . . � . 7ot area Sq. Pt:.
<br /> . �`_ .:. = . � �• �Size of Llcg. Sa. Ft. �
<br /> ' . ' • ]7uiabor of titorics �
<br /> ' ': -. � . • ' � Basc:�ent -
<br /> .:. . , � � � . -------
<br /> � � � . S�l'gncd By
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<br /> • _ . � For. __� C.t 7,_ �� �._I_�.�. ,.�_ , '
<br /> . . . . . _ . .. .. Ocancr rnaic .i -� -f _1J.�:� ,
<br /> � � �_, PO \O: Si:t?P� I3?LO:I T11I� LI;]i�.-FOR Ci7'1' JS;: O;:LZ �
<br /> . Datc ��cc_ved - � � U�e� 7.on� �
<br /> � ' Plan C:�ec.`., ::nr.,:cr ' ' Pirc 7,onc . � '---_...
<br /> . . . .Valua;.ion � �iJl��. �.C' _ Ocr•,innncy Grou�� . ---�— � .
<br /> - Pc:niti I'cc � _ � _� 7yr,e of ConstrucCion
<br /> Plan CLec): I'ce �—^-- Oceu�;;�r�L Lo�d • - --
<br /> . : iUC.11 Pcc DuC �� SpYltil:lci.^. R��r1u11'ed _— ' � � .
<br /> D1.ta 7:.^,uc�l � � � w . . ; . , .
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