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1c <br /> E <br /> � � SOZLDING PERMIT APPLICIITION ' �/q ' �� -. � <br /> , � . Applicant To Complete This Form � 9 .� /-/ '��•� <br /> . , I! oore ihan one buildinq is to be contructed, submit a se arate 6/3 a/��', <br /> . , • t i o n f o r e a c h bui l d in A se arate p P�n^i ti a P P l i c a- <br /> , 9• p permit will be issued for each buildinq. <br /> . . � � O�mes C_�E� N<",E �� ?, �,�;- snildinq Addzess �S O� �- �= ��� '�--. <br /> , ' . �ddresa L`� G1�1 I i -i i ) -T Lot Z, elock �'Z . <br /> , CitY �VE12e1 I Phonezs'0I -2`f2 � Subaivision (21at) �lF-��,��.,.r : <br /> . ' • �schitect/Enqineer � . . <br /> -' � '� ��'�j «tY p�e ![etes i Bounds (Unplatted) <br /> :� Oontractor 6 f=L� Sec. rip. �tQe � .. <br /> .' %" ideress l� . . . <br /> !; Citp 11 Phone II Dnildin Use ` : <br /> 4 �C-��1 f� 1� 1 � �J (�a•���`a.�:'••... <br /> i`f . � . , ,,., <br /> • : .. <br /> � ' :'� Stata License Nmober � �•• " <br /> � � +f Describe Work to Be Done�iJ��� Q� � <br /> : �I L�iration nat� ' RC. (�'�Ol>'�l _ - i�s-cq�.� u�-.+� ti-i.�.tJ <br /> � y1 : "� . . Sl�'TCN PLOT PLAN BEIAt4' � .PAR"(�-(iOr--) - crl�-( R..�tiL -fA z - �u <br /> • . � � • _ . ' • w�ZH �/q" FiRt �Rf.-t�� r.-.i� R,�A2D. � � � <br /> :.) . . Osa of Bu3ldinq <br /> � .. • • • . . . ' ❑New ❑ Addition Repair/Remo:<el <br /> � � . � • . • 'Valuation of Co� ?truction $�_� <br /> • . <br /> � . ' • PLOT PLAN REQUIREl�1ENTS . <br /> . , . <br /> . �• ,� ' • ' ' Indicate lot size, name of streets, •+ <br /> � . . ' indicate location and width of <br /> ' • ' alleys, locate pr000sed and all <br /> ' ��� existinq buildinqs, show distances ' <br /> ' . "' 7 ' to property lines, show distances <br /> + � � � . • between buildings. <br /> . , . � Lot eize x <br /> "' ; � , Lot area Sq. Ft. <br /> �` .•• ' Sise of B g. S Ft. <br /> f . • Number of Stories q� <br /> ' ': ' �. • Sasement <br /> .•. <br /> , -- • <br /> � =' Signed By � � <br /> ' +- For <br /> O�rner Phone <br /> � DO :IOT Si:t2TT'. B�LOI'1 THIS LI:IE-i0R CITY USz Oi7L'f <br /> : _ Date Received (2 /� '3c•�Z � Dte� Zone <br /> ' Plan Check :7ur.Ser ' Fire 2one - <br /> Valuation ' �� �d- � � � <br /> _ Oecunancy Grou� <br /> Peznit' Fee �� � o . <br /> Type of Construction <br /> Plan Check Fee Occupant Load <br /> . ; ibtal Fee Due < <i- �-� Sprinklc`rs Required ' <br /> Date Issued ��7\� • • , _ <br />