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--. __ __ ._ . _._ <br /> BUILDING PERMZT APPLICATION � /�O �/ �! # <br /> Applicant To Complete This ?orm �/��/�� <br /> If more than one building is to be contructed, submit a ceparate permit applica- <br /> tion for each buildi� A separate permit will be issued for each building. <br /> �e1 � Buildinq Address �'�/,,�,jft_ �� 7,y��ap� • <br /> Address � � Lot 1�/ Block ,',�S- Q-o0 - <br /> City � � Phong-��'a-�jaao�, Subdivision (Plat) ���Q� tp <br /> Atchitect/Engineer � � � ��5'�, <br /> City � Phone �. Metes & Hounds (Unplatted) <br /> �� o <br /> Contractor �'��n p�' �� t �(�O��Sec. '1Wp. Rge <br /> Address � . <br /> Cit`p C� Phon �`� � Huilding Use ' <br /> 0 <br /> State License Number ��-Q� -( 14a� Describe Wozk to Be Done 1(1��� <br /> v�� <br /> r n� 0 <br /> Expiration Date `p���jY �� � 1(�%t0 ��lt_�n�". �'�-1L IC� , <br /> SRETCH PLOT PLJ�N BELOTJ - <br /> Use of Building ' <br /> ' U New ❑ Addition e air�/Remodel <br /> . Valuation of Construction $ l�� ^O� ` <br /> . . � • • PLOT PLAN REQUIBEtdENTS _ <br /> Indicate lot size, name of streets, <br /> . - indicate location anfl width of <br /> alleys, locate proposed and all <br /> existing buildings„show distances <br /> + '! to property Lines, show distances <br /> between buildings. <br /> , Lot size x <br /> Lot area Sq. Ft. � <br /> �:. ' Sizz of Bldg. Sq. rt. <br /> . . . Number of StoFies � <br /> � . Baseme.t <br /> ' Signed-B � � <br /> For-- � C�p� . .(�l�C� ,��� I <br /> Owner h�on�• <br /> i <br /> DO NOT WRITE IIELOC7 THIS LINE-FOR CITY USE ONLY I <br /> Datc Soceived <br /> U�e Zone <br /> Plan Chec6, �:u��ber £ire 2one � � <br /> Valuation�1���1.. �� Occuoancy Group <br /> Pemit Fee � �� — - I <br /> /¢ • Type of Construction ! <br /> Plan Checl: Fee Occupant Load j <br /> Total Fee Cu� Sprinklers Required � <br /> Datc Issued CITY OF [;r'^r; ;— <br /> APPROVED FC�? <br /> _ � ;,a.iir <br /> o,,, . ' <br />