Laserfiche WebLink
` w <br />. ,, <br />• DUILDING PrRMIT APPLICATION • ��3� � � �• <br />A �licinL- To CompleL•c '�lii^. rorm / <br />. p� , . . �jl�,�.z 7,E <br />If more than one buildinq i,�to be con�trnctcd, submit a sePar.�te per.mi.t <br />applicaL•ion L•or each building. A �eparate lieLmiL• wi.11 be is�ucd for. each • <br />building. <br />Owner atirk�-c,� C��.f�i�+� � '�ILS <br />Aadress �3 3 Z��. c i�rG✓ <br />City Fv��iv� Plu�,e aS`� C�c� I <br />Archi:ect/�ngincer <br />City Phone <br />Contr�ct;or .,�ja w. r�- <br />Address <br />City Phone <br />State License l�umber2�3u� -/6'd'2 (� <br />Expiration Date <br />C01�*�__. PLOT PLAt7 0?: REVERSE SID; <br />• 2Zl !o <br />IIuildinq Acldre� � ��ur.�'` � <br />LoL• 2 S �- �- 6 131oc1: <br />Subdivisiwi (P1aC) S�,Nti�s;�.lr� <br />��., <br />Metes & IIound� (Unplattecl) <br />Sec. Twp. _ Rge. <br />Building Use ��EJ iG�A►,-ci- � <br />Describe Plor}: to Be Done <br />G�'+,- S� (%'� � �L <br />Number oi Stories C�J�'1��- <br />Basement /(/u <br />� �Net� Addition Repai.r./Rerlodel' <br />Valua ion of ConsL-ruction $ <br />� e� . <br />UoG <br />Signed IIy <br />� <br />For n�. �� � c•�.. ',-. �! ,��c <br />Owner � Phone2-c'7 / �•� ! <br />�• Do rot t•7ritc Belo�v Thi� Linc -I'or City Use Only � <br />Date Received � �p � ' ' ' ' ' - � Use Sone �-Z Si.�i - � � �t <br />Iflan C:�eck Number (p — I � �o • . Firr. Zone � <br />Valuation �Z�C��c.� -`'= ' • _ Occupancy •Group <br />Pemit Fee _ •�/�' � O . Type oi Const:ruction ' <br />Plan cl�eck r• ee ' S9� `�" � occupant Load <br />Total T'ec lluc f.� �- °a Sririn)cicrs Requircd <br />DaCc Is�ued <br />� . . <br />