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' � � DOZLDING PERMIT �PPLICATION � � ' ' <br /> • . 1lpplicant To Complete This ^•orm /�/j•� <br /> If more than one buildinq is to be contzucted, submit a separate permit applica-�j <br /> tion for each buildinq. A separate permit will be issued for each building. J� <br /> � �u' `l�='�it (� F S'�'{'����. , Buildinq Address ��_5( � ���( � i� : <br /> , . llddress ��j I� ����J7� Lot 1 �- z Slock � �" Z ' <br /> � <br /> City ��}��� Phone?5{{—Try�7(� Subdivision (Plat) ��'��(�(`� / � - <br /> ' � ]Irchitect/Enqineer ��Y�f, (S � � <br /> :..i • •�--, <br /> _ City �7l;(, �f?�-{3� Phone Netes i Bounds (Unplatted) <br /> , Coatractor "'�}�L� Sec. 1k+p. Rqe <br /> . llddress ' • <br /> City __ Phone Buildinq Use .�i<�_' <br /> �- . ;i State License Number � Describe Work to Be Done � '���� <br /> � : I Espiration Dat� '��F--►s� pq:h�t �� �,� ' <br /> '� ' - � - SICETCH PLOT PL11N BELOfQ' • TJi— OC, . ' <br /> _ . � <br /> i . . � <br /> � . f . IIae of Building � <br /> 1 <br /> ► , � - .' . , . ❑New ❑ Addition Repair/Remouel <br /> . � : � � � � . . � � 'Valuation of Construction $1 )'—� �� <br /> • . <br /> �� '. . - � . ' ' . . PLOT PLAN REQUIREMENTS , . <br /> . . . <br /> � � ' Indicate lot size, name of streets, <br /> ' ' ' indicate location and width of <br /> � � • alleys, locate proposed and all � <br /> ' � ' ''�� � . . . existinq buildings, show distances <br /> � _ . i '� "� '! . to property lines, show distances <br /> � � • betveen buildings. <br /> Lot size x <br /> •• ` Lot area Sq. Ft. <br /> � • ,•,. • • Size of Bldg. Sq. Ft. <br /> ` = , � 2lumber of Stories � <br /> .:. <br /> j : . Basement <br /> � . ` � Signed By� j�i' <br /> • • For <br /> � Owner Phone <br /> DO NOT Sv'3ITL BS:.OI9 THIS LI:IE-20R CITY USz 0:7L'i <br /> Date �eceived 1 �S� U�e Zone <br /> ' Plan.C;iec;: :lur..Ser ' Fire Zone ' <br /> Valuation y-��� �` Occuoancy Group <br /> Pemit Fee �j , B� Type of Construction <br /> Plan Check Fee �r Occupant Load <br /> , ' Total Fee Due S. �� Sprinklers Required <br /> Date Issued S � � � ; . _ <br />