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• � � . • . . - .. ' ._i
<br /> • � ' ' ' ' DOILbII�C PEtiM:T nPPLIC11TI0ti � � � ' � �� t
<br /> _ _ . , , :.,•i
<br /> _ • . . . : Ilpplicanl- To CoinpleCc Thi� :'orm , ��, , 'r,
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<br /> • • � I! norr_ than onc Uuilding is to bc contructed, submit a �eparatc perniL• applica- I
<br /> ; tion for c�ch 6uilding. A separate permit will bc issucd Lor cach Uuil.diuy.
<br /> . � ' Omer.�� ���ew lluilding nddress �oZ/l`� ���
<br /> ' • _ 14ddres3 a I/ `� ��— LoC �-/ nlock �v �6'
<br /> .• ' , City �'r2-�-�C�'r Phone Subdivision (Plat) ��_ �
<br /> ' � ?schitcct/�ng:ticcr � ' ��J 4�
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<br /> •:� '"� City . Phone Pfetes 6 �ounds (UnplaLted) �'
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<br /> � . ;,'. Cuntractor ������ �' ,^,ec. �i. Rge ..
<br /> . .., . . .
<br /> _' . ' .�LDress �� ao�/.� ' -
<br /> ' , - G T � � .
<br /> . •' -.City �c�U Phone 337-5/7-at �Building Use �C�..-��
<br /> _ ..•:`; , :. :. . . . • -�•�
<br /> Stzte License t7�.^aber .� a-��� � 6 ��f D cribe S7oz1• to IIe Done '�'' y
<br /> ii ' �
<br /> _ , � �� . ,
<br /> : :• �i Ezpitation DatZ � � CL�"��r�"�`�-v•
<br /> . ��: '" . .. StSTC11 PL'Oi PL:ti*I IIELOS•7' . •. . , �
<br /> - '.� • — . , � . .
<br /> . ;.� . . . . , ' . . . . IIse of.IIuildir.g ' --
<br /> ♦• : � � �� , _ [�t�e;a ❑ ndditio Rc r/Remo:3c1
<br /> — , .. �� • • , ' . :� � . oO . .
<br /> '�;• �� ���• � �� � n � . - Faluation of Construction $.2500 --
<br /> • ' �¢,vHewLJ�'_'n���. LC-e�/- , .
<br /> ,,.r,., .. � . . `�, ' . . � :PT.OT PLI�N R:QUZRI�':;:TS , .
<br /> �.. °� ' . ' .. . � . �
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<br /> ' i • • • � � • • ' Indicate lot �iae, nane of �treet^., .
<br /> . ; .
<br /> '. � ,�e� . ' ' rindicatc locztion ar.d wi.dth o:
<br /> • .��i * � � • alleys, 'locaL-e aroposed a.-.d all .
<br /> �' ,',�.¢..°�,,�'..
<br /> . • +''� . .exicting buildi.-.gs show dis.snces '
<br /> _ . j ? � ' ,� ��' �'= . . -.Lo property lines, ��ho:� distance�
<br /> .: ����/ ' ' '
<br /> , ; , � A ._" " ".1 �? - betwecn. liuildings.
<br /> . , .
<br /> : ; �.. ���... .�� . Z.ot �iza x . '
<br /> , q
<br /> .:- ; �2Q � G�-�-"""-"--Lc,.O �: Lot area Sq. Pt.
<br /> ,.., . Size of &ldg. Sa. Ft.
<br /> ' ' : .: � a Iiucibez of Storics
<br /> . :: . ; � �`'�� ' . . IIa�eaent
<br /> ,:. C • �, �
<br /> � '?.� ' , Signcd IIy
<br /> � � . ��_ .
<br /> , . , ror •
<br /> . . . . � � , �, • Ucancr Phonc _
<br /> ' ' PO \0; liZIiB �-7.0:4 TI:IS 7,I:1,�.-POR CIiX i15:: O;IT.'1 ' � .
<br /> Detc `.:eceived � Uce• 7.one
<br /> ' Plan C:�ecn :7ur.bcr ' ' Pirc 2onc "
<br /> Va2uation � Ocr.unancy Group �,
<br /> 1'csniti Fce � 7ypc uf Con.truccion
<br /> Plan Gicc): L'cc ` � _� Occup:�.nl 7,oad
<br /> . ictal Fce Uue �SrrS.r.l:lcra Ra c � _� :
<br /> .. . -- • ��`I Y �F E��RE�--
<br /> D:fe as::uca � • � � � APPRQV6D FQR��•BUILQING PERMIT .
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<br /> '. . ' ' . .. ' . , . � '�ate��-?,.�`—E3y� � _. .
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