Laserfiche WebLink
BUILDING PERMIT APPLICATION / (` � `r`� <br /> Applicant To Gomplete This Form 0. � <br /> P�ny/� <br /> If more [han one building is fo he constructed, submit a senarate permit � <br /> application for each building. A separate permit wi11 be issued Lor each <br /> � huilding, "`� . <br /> i <br /> _ Owner � j-"�� � �'.�%' ��J Buil3ing Addreas � � �--' '�-�• � �-� �-^ I•�' _ , � "� <br /> Address ' � � Lct��-��"<^Block '� � <br /> I '� � <br /> City ��<"7'�.�7� Phone,�,> (7-•�� jSubdivision (Plat) � ��I-:-�-J�-`�� / '-'/�; <br /> AreLitect/Engineer <br /> City Phone Metes & Bounds (Unplatted) <br /> Contractor � Sec. Twp._Range <br /> Address <br /> - City � Phone Building Use <br /> State License Number Describe Work to be Done �JnJti�,- i. �<; <br /> Expiration Date __ Sv��v.i.'r',. _ :-.i� �-' /J.`_�!r^�� <br /> SKETCH PLOT PLAN BELOW � <br /> Use of Building� � <br /> I <br /> .� New L7Addicion ❑Repair/Remodel <br /> � Valuation of Cons[ruction S.�OQ �� <br /> ------ .� ��,__ � PLOT PLAN REQUIREMFNTS <br /> i <br /> Indicate lot size, name oF streets, <br /> _ __ � �L indicate location and width of alleys, � <br /> � — -'—" _ _ loeate proposed and all existing <br /> �f buildings, show distances to prop- <br /> ' ��� erty linns, show distances between <br /> , �-� buildings. <br /> - � : Lot size x � . <br /> �.(t I �Q O . <br /> 0� Q- � Lot area Sq. Ft. , <br /> � � � �� Size of Bldg. Sq. Ft, <br /> �i� <br /> ''I ----- M Number of stories <br /> � � � ` Basement - <br /> N ; 3 � ; Signed By Datc <br /> i �> � <br /> For <br /> —�-_`_—-- -_ .. ,-_ '��.,., Owner Phone_ <br /> -- -, Lr4 ��-� <br /> , J e. <br /> S� LJ�=r` DO NOT WRITE BELON THIS LINE - FOR CITY USE ONLY <br /> �c> � <br /> Date Received Use Zone <br /> Plan Check Nu�nber Fire Zone <br /> ' Valuation Occupancy Group <br /> Permit Fee Type of Construction <br /> Plan Check Fee Occupant Load _ <br /> � Total Fec Duc Sprinklcrs Required <br /> l':, <br /> . Patc Issucd <br /> �� <br />