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: <br /> . ,. ..1 <br /> . /�, . <br /> , <br /> . . �i ' ' � ' 190ZLDING PL"RHIT APPLICATION � . / ���j.'•'•, � .�;j <br /> � �• i • � �Ipplicant To Complete Thi� _orm �/�/�S , , ,i <br /> . . ' Zf cwrc than onc buildino, is to bc contructed, submit a :eparatc pcimit applici- <br /> � . , tlon for cach buildin�. �l sepnrstc permit will bc issu�d for cach buildinq. <br /> � c�er ��/� ��� G��r �\ Huildinq Addres' � / � � a2 ��'`i'�2�� = <br /> a; <br /> �.�.-� ilddress j //�—�h. /PA W� bot Block <br /> '��'' �ty �J�R�*� Phone ��-'� d �j Sub3ivision (Plat) • <br /> � " . <br /> ' • Erehitect/Enqincer ' ' <br /> •:. ''"� City Phone Hetes & IIoun3s (Unplatted) <br /> - 1 .. <br /> . ' , :�•: Canti:actor Sec. Tc,�p. Rge � <br /> _ :. ' J3dress . . � <br /> . f -LYt Phone 'Auildin Use � ' � . <br /> .. Y 4 � . .�-' <br /> - �'�7 � Statt.License N�.�-iber Describc Work t� Be D � e y" V <br /> � • �:. '� 2�isation DatB ' _ <br /> �� ' '� � = �SF•ETCSi PLOT PLAt1 BELOSP' • "t'�+- _— . <br /> . <br /> , � � + ' •• '. � . . Dse of 3uilding ��_ _ � <br /> �. � ' . ;_ ' _" . ; nNect ❑ Addi.tion �epair/E.emo::cl <br /> '� �. .. • . • . . ,Valuation o£ Construct_cn $� - . <br /> � .. � ' . - � , iPIAT PLAN R?CUI^PI•SJ;�TS , � <br /> ti . . . . . . - � . <br /> � • i • • • • • . . � ' Indicate. lut si.ze, na.�e nf streets, <br /> • ' i • - ' 'indicate loc,tion ar.c width of <br /> . ,. � - " i'�' �, . • alleys, •locate aroposed a:.d all - <br /> • ;-' � ' ' • � ' � .existing buildiags, sno:a distances <br /> ��?� • _,-. - -- y ; ' . • �= ' . . -lo property lines, show distar.ces <br /> " 't � - _,bet�reen buildings. <br /> , : � ' -� ' . . . . <br /> ' ' • .' � • + " S,ot size x <br /> � . � . . <br /> „ . � • ' . I�t area Sq. Ft. <br /> •, r . : , • . Sizc of IIldq. Sa. Ft. <br /> � j • • Numbez of Stnrics <br /> , ' •,: , y� � . , • Dasenent <br /> ... _ . � � • ����� , ��!/ , <br /> � . Signed IIy .. <br /> � . . . . <br /> . '. . For _ <br /> • � • — Owner Phone <br /> ' DO N0:' P::tT_T' 9�LOt7 THI� LI;v"r.'-POR CiTY JSE O'IL'! _ <br /> . / /., , <br /> Date ::�ceived f�l� 7 � • • Ute• 'Lone <br /> ' ' ---� . <br /> ' Fla❑ C:uc� _7u�Scr ' Firc Zonc _ <br /> \'aluation � � ��� �G, Occuvancy Grou� • <br /> . . . � �G - <br /> Fa�:�iti Fcc �l� � Typc of Construct:ion <br /> Yl�n Check L•'�e ' Occup�r.0 T.oiQ ^ i. <br /> . . �_�J . . <br /> , � 9bta1 Fcc Uuc �j . __ �pr.inl;lcr� RequJ.red -- <br /> . , ---��-��- � . . : . . . . <br /> n�cc r:::-:��a � • , , _ <br />