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App11c.^t 't'o ccnpir_cc :ois -uu�� � <br /> Lf more than one buildir.g is to be contructed, si:bmit a separate permit applica- � <br /> tian for each buildir.9. .� separscc permit •+ill bc issued °or cadi buildir,g. <br /> �c.1 � laeh, � � Q '�'� � <br /> �Ar Buildin Address � `� U�2 N�'`�' <br /> Aaaress �qn a /-I c- ,.� � � Lot G - /c� Dlock. G-- 4,5 <br /> City �� c ii e Phone ���'�`C�� Subdivision (Plat) C ���/3�3�5 <br /> Architect/Engineer. Sfi(� . �a 1� SitJ/� I���IIS—� ���� <br /> City C V Phone Metes s Bounds (Unplatted) _ <br /> Contractor .Sr �� S��' 'I�'' Rge <br /> : ' Address <br /> City - Phone Buildinq Use f " -o�' "-' � <br /> State License Nunber _ Describe Fior;c to Be Done " ' oj P�, ' <br /> Expiration Date _ � <br /> SRETCH PLOT PL71N BEiO'.J <br /> Ose of Buildinq <br /> _ ❑New ❑ AZdition (�epair/Remodel <br /> � Valuation of Construction 5 O UO <br /> i � . : PLOT PI.11t] REQUIRESfE::TS � <br /> Indzcate lot .size, name of streets, ' <br /> indicate location and width of <br /> alleys, locate proposed �r.d all ( <br /> existing buildi�qs, snow 3istances ! <br /> � � to property lines, show distances I <br /> between buildings. <br /> Lot size ,32.5 X / �g <br /> . � Lot area Sq. Ft. i <br /> Size of Bldq. i .�r7 O Sq. Fc. , <br /> • � Number of Stor:es / <br /> 9asc.^..cr.t N�� <br /> Signcd Hy �CJ /J �"Q-r-��� <br /> �, �, <br /> For <br /> • Owncr Phone <br /> �0 NOT S4RIT6 9�T_OY7 TNIS LI:�E-FOR CITY USE O:ILY <br /> �n'c . .cn's•:o:'. �_�` �i.l�— C4e Zone - — <br /> �.��_ Fire �one <br /> p?�n ....cc�: -- _---- <br /> Valuation Occuo,incy Group — <br /> Pernit Fec Ty�e of Construction <br /> Flan Checl; Fee _____ � _ Occupan: I,oad <br /> ` Sprinl:lcrs Required � <br /> Tota: 'ree Di-' ._� . , ` <br /> �at� I�_�l�d _ CIrY Qf [V[RETT <br /> — APPROVED FOR QUILDING PERfell i <br /> Date BY <br />