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<br /> -- '. � � � ..,. . . � SOZLDING PERMIT HFPLIC]ATION �.�p�� / -� .�� � ,L.;.� •
<br /> - :' � ' , : Applicant To Complete T:1is ?orm � 3 a �//�/,L
<br /> , • � I1 more than one buildinq is to be cont:ucted, su6mit a separate permit applica-
<br /> . , tion for each buildinq. A separate permit will be issved for each building.
<br /> �7 i1,
<br /> , �er ��� n�n� c� � h 'F��;i.���' Haildinq Address
<br /> ' , ]Iddress �,;� ,� �j ��r, � i �� -(�, Lot Bleck •
<br /> City �i� fi�� � ,H- Phone.��5�- 5/�� Subdivision (Plat) �
<br /> � • Architect/Engineer �--`
<br /> '"� City ' phone Metes 6 Hounds (Unplatted)
<br /> 'i �—�
<br /> : �
<br /> . � :,� Contractor ��+��;�c �;�„ �� ��n-,..f.. . �Nc.�ec._ _ 7t�p. Rge .
<br /> ' ' llddress � y I b - �t i_ ;� w' , � •
<br /> ! Cit � �f Phone ��rr�-�� Builc;ing Use ��; � • �
<br /> . Y Yar �.l �.. _ � _� •� _
<br /> ^' . ., � v , � •
<br /> �� � State.Licer�se Nur,.:er -� � �- C :':_�,� 9escribe Work to B= Po^e ^�'� � -
<br /> � `,1 EiPization Date � -
<br /> . _ — ' _`�� � ' et e,� '
<br /> '.� ' - � � SKETCH PLOT PLT�I7 HELOW' • �
<br /> . ' . � _��-. —��_.�l�_'��'i`�� ,�_�yDse of Duildin4 'R �'-S ,, C c.., c� •
<br /> a .� :� . . . � • I _ . , � �New ❑ Addition ❑ Repair/Remo6el
<br /> " ' 1��� : q : I � Valuation of Construction S .1�p�, nr,
<br /> .. I r � y _ .
<br /> � '. . . . .'.�/ 5� � � . . PIAT PLAN REQUI?t&`tENTS �� �:-�iLy{`,' I r
<br /> f �- ; � • . �r'�Q� � _ . � • � ��• c - Indicate lot size, narc:e of street5,�� �
<br /> il
<br /> ! , , �' -indicate location anc width o�
<br /> „ . allcys, locate nr000sed and all �
<br /> . ;' � . _ � . � : - . . . existing buildiags, sho:u distances
<br /> . . '•�'9 to property lines, show distances
<br /> , ' � r� - between buildings. �
<br /> 1 , � � Lot size x
<br />� � •- � ` ' � �� � , Lot area Sq. Ft.
<br /> • �,. - f � ' • � Size of Bldg. Sq. Ft.
<br /> ` � Alumher of Stcries
<br /> �� � ,i, 'h . ' � � Basement
<br /> �� .,� ^- - - `^ Signed Sy i l� -�t. �.. ��,4.L��,
<br /> ; y . . � T—
<br /> ' • CAi Fox��_ � �i�rrr� -c-
<br /> . ner Phone �j JL� : �-Y�
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<br /> � DO i70': I•:ZIT� B�LOt'I THIS LI:JE-cOR CITY USE OiIL'L
<br /> - -- Date Seceived � U:e Zone
<br /> ' P1an�C:icck :7ur.,5er ' Fire 2onc '
<br /> 'Valuation 0=cupancy Grou�
<br /> Pemit Fee � Rype of Construction � �
<br /> Plan Check Fee Occupant Load
<br /> . :ota7. Fee Due Sprinklcrs Requirerl
<br /> Datc Issucd � � � � . ' . _ , �
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