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_.� ; sOILDING PERMIT APPLICATION � 3 �� <br />- ' . lpplicant To Complete This :orm •� . <br />. , ��.S;,�s <br />. • If ooze than ,ne buildinq ia to be contructed, submit a separate permit applica- <br />I: tfoa for eact, buildin?. separate permit will be issued for each b ildi <br />� . , u ng. <br />'�.i Wnes �' �t:^ ' �� � !C (i � :� Bnildinq �lddress � ��a'�/ �/': f�ia/�/' <br />' : 7�eares, �`�.") � j '= ii �` '- �,ot �s+`- I� � <br />. n�o�k a a/= D- oQ . <br />,_- , i l / <br />� City � G�/`��� Phoneti���7-��/� Snbdivision (Plat) Sc_�.�i7USitle ��`��/�D <br />_ � • hitect/Enqineer � S %,:y�` f' cE/, ��� 7/ � • - <br />_� i �='� �tY plwne Metes i Bounds (Unplatted) <br />�i <br />, �- : � Contsactor � Sec. iwp. Rqe .. <br />, <br />� -• address <br />' CiLy <br />�� State_Licens <br />� ; � �t L=pirati Date <br />Hnildinq Use � ?•; ` � <br />, �' <br />� Describe Work to Be Done C c `' <br />I Ll, ' . ' - ,` �-� ' .. <br />� i- L� A-' I �0 Y C Il <br />�� ' � SICETCH PLOT PLAN BEIAW <br />. . i . <br />::1 � <br />�. � . <br />•.�' ' <br />•. <br />: � <br />� . <br />• i . . . <br />• '� 1 . <br />' . <br />_ , '.1 ' ...- • -'y <br />. �; ' � <br />` � • <br />a <br />. <br />� Ose of euildinq �iiU� -�as{,•�y � • <br />�,_,/ . <br />�New ❑ Addition �itepair/Remo:iel <br />:` <br />Valuation of Construction S�.S l). oCJ � <br />. , YLOT PLAN REQUIREFIENTS , <br />Zndicate lot size, name of streets, <br />indicate location and width of <br />alley3, locate pr000sed and all <br />existinq buildings, sho�v distances <br />. to property lines, show distances <br />beiween buildings. <br />Lot size x . <br />Lot area Sq. Ft. <br />Size of B q. �_ Sq. Ft. <br />Number of Stories <br />8asement <br />� <br />�'Siqned By � 7°� �� i���_c,_c_.z� <br />For � J�r ,•ac <br />Owner Phone.-7_Ta -ie �i9 �/ <br />' DO :10T SC:2ITi BELO['I THIS LI:IE-iOR CITY USE OiiL'L <br />Date `:eceived IIce 2one <br />Plan CSeck :7ur..Ser ' ' Fire Zone ' <br />,Va2ua:ion Occunuacy Group <br />PemiY Fee Rype of Construction <br />Plan Check Fee Occnpant Load <br />� Total Fee Due Sprinkl�rs Required ' <br />Date Issued � � . . <br />