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' ; ' � � � DOZLDING PERMZT APPLICATI�N �. . � �' y� <br /> _' ;� � � , : �plicant To Completc� This :orm � �`'�d �6f� <br /> , • � If more than one building is to he contructed, submit a separate permit applic�` 1s�� <br /> , tion fos each building. �1 separate permit wili be issued for each building. <br /> �' Oraer GJ. {i. �,'/G.C�L:t_+:,p,�.1 Buildinq Address ��1 � �GF`/`-FJ<-.SGti1 <br /> y— /�/ t�•o� rG c ��. <br /> , lddress �' 924- �./f.�--{25G�,�L Lot ��r-, ��_:'; Slr_k 2/ • <br /> City �lJ�'L'L;`�- Phone ?�SS-7��5 Subdivision (Plat) • ' <br /> ��� ''7 . <br /> ' 1rChitect/Enqineer � Y"/�c/f:rr�.1i'. ✓%G�: f� <br /> :� City Phone Metes i Bounds (Unplatted) <br /> - - t .. <br /> , Caatractor ��L.I- Sec. Twp. Rge � <br /> ` l3dress ' ' ' <br /> ' City Phone Buildinq Use � ` �•;:;>'�. <br /> �ii .;;. � . . . • �' -. <br /> � ;;� State.License Number Describe Work to Be Done �', . <br /> . • � 'I Lipiration Dat� /.1r�f�i T/O.c_� - ��.�JlZ<�C>�J � <br /> �� : . . ' � S1C£TCH PLOT PLAN BELOW' . • . . � . <br /> ' ' I . • <br /> . : { Dae oE IInilding �J,eQ�J�-y <br /> 1 <br /> a � , � , , , �New 1�'Addition U Repair/Remo&el <br /> . . , ; . <br /> 'Vnluation of Construction 5 . <br /> �.... • � � - , - � ��� . - P7AT PLAN REQUIREI�SENTS . � <br /> � � �� . � � . ' . <br /> � • i .. . � ' �� . � � <br /> . Indicate lot size, name of streets, <br /> . ' � --'-' -- indicate location and width o: <br /> � . � � •� � � � � � � �'���• � = � alleys, locate nroposed and all � � � <br /> - ?�'j 3� / ' . � •�. existing buildings, show distances <br /> 1 '� '� . ' �'- to property lines, show distances <br /> � � � � e . � betWeen buildings. <br /> . � .a. , � � IJ . ' T.Ot S1ZE X . _._ - . <br /> ... . ' � ¢ �• . Lot area Sq. Ft. <br /> r, � • 1 Size of Bldg. Sq. Ft. <br /> � ; • ! Number o£ Stories <br /> . "'.; ..j � . � � . . . . � _ ,Basement - . <br /> :.. - <br /> '� ' . ~ � Signed By • <br /> I _� 7J � / � I `( � <br /> . j 1 � j(FOS / / V��LL..✓L/ f�i L L J. i ! L <br /> . . . .. J�-���''�`"--�'^�-�1'� . Owner Phone <br /> � - � � DO NO'i SC:iIT1T. B:L0�9 THIj LI:IE-20A CITY U52 ONLY <br /> ' Date Seceived �l S �� �� 77ce Zone <br /> ' Plan Chec� :7ur..Ser ^� � Pire Zonc ' � <br /> `�alua:ion ��- �� ��� <br /> Occunancy Grou� , <br /> Peznit Fee C ��� C� Type of Construction <br /> ,' Plan Check Fee Occupant Load <br /> , C �� <br /> Sbtal Fee Due <� � Sprinklers Required <br /> • �h / � <br /> Date Issued �t- �5 '�]� � �. : , , . � � <br />