Laserfiche WebLink
i <br />. �i G �_ <br />' //js'�G <br />BUILDING PERMIT APPLICATION <br />Applicant To Complete This Form <br />If more than one building is to be constructed, submit a separate germit <br />application for ach bui•din . r separate permit will be i,sued for each <br />building, �% � //� % � <br />Owner �+ L'LC� � 6'�, L Buildin9 Address -i c�'C' � x-L <br />Address � i' � i(f . Lot Block <br />i <br />City � i � Phone ����J. �� Subdivision (Plat) <br />Architect/�ngineer <br />City Pho e � <br />Contractor �` 5� � � �- �S 'G �'�' <br />Adflress ! L7 �_ C' �C � � S% <br />--•- <br />City Phone <br />State License Number o�,�3 �� ����.J`_s <br />�xpiration Date <br />Metes & Bounds (Unplatted) <br />Sec. Twp. Rge. <br />Building Use � " � .(�f -�� � � <br />Describe �9ork Be Done <br />�� ��� N - -- - <br />Number of Stories <br />Basemen� <br />New Addition Repair/Remodel <br />Valuation of Construction $��.� C� <br />Signed IIy <br />For <br />Owner <br />��, <br />Phone �� �-'. /G� � <br />Do Not Write Below This Line-For City Use Only _ <br />DaL•e Received Use Sone <br />�Tlan Check Number Pire Zone <br />Valuation �� .��� Occupancy Group <br />Permit Pee Type of ConsCructi.on <br />Plan Check Pee Occupant L'oad <br />Total Fee Due Sprinklers Required <br />Date Sssued <br />