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� <br /> _- , .. �. . . . . , . . . _._/�.,�_. . �. .�� <br /> �� � " ' � ' 10ILDING PERMIT APPLICATION /`7 �f� '. ',.,,,j <br /> �pplieanG To Complete This Sor.n � �' ; � <br /> , • • ' � u n�re than onm buildin is t� ;�e coneructed, submit a �e ara"n /a/�S�f• <br /> 4 P permit applica- <br /> . . tlon for each building. �1 sepacr„te per.nit vill be issued Eer each building. <br /> n, /'7 � <br /> . ' � Orner '.��.�.y L� Dnildinq Address �,-�I�� CT/',,�� , <br /> . � � � �ddress "CY.� l �� Lot �`�Z; h.:uck �� <br /> • , C1Lp -P PAone Subdi4ision �Plat) � �� p�-p� • <br /> : ' - �tehitect/En3ineer • � . . <br /> • �_ I . <br /> _ 't ; . •.`i Citj Phone !(etes F eouads (Unplatted) ._ • <br /> • i • ' - <br /> :�'. Cmtzaclor . ' Sec. SMp. Rqe , <br /> � . •_ _ <br /> � ;. . �• �ddsesa � ' ' • <br /> .. 'f City Phone enildinq Use 1�U '7 7-7�' •:'�:_ ' <br /> ,�.... <br /> '�7 . �� ' . , �.:ti�.::;�.,.. <br /> �// �...� . <br /> �� �'rj State.License Nuenber Describe Work to Be Done <br /> . i �LS�. <br /> : . �i Lipiratiaa Dat� • � a� �n'iyj7�y � _ . <br /> ��' � • SI�TCH PLOT PLAN SELO(P' • ' <br /> _ •l. ,.I • , . • IIse of Buildiriq � ' <br /> � <br /> a• � ' ' � � . � � (]New ❑ Addition � Repair/Remo�el <br /> . . . �.:' . � . • . ; � ' • �ii <br /> ;• . " . - � ''sluation of Construction $.�Oa ' <br /> '• • • _. � <br /> `�. . '. � '. _ . �� ,..• ' • .. . . � . PLOT PIJ1tI REQUIREFIENTS : ' . <br /> . • . . . . . ' . �.; <br /> ,• � � ' � : ' ' ' ' Irdieate lot size, name ef streets, <br /> - • 'iadicate location and width o: <br /> • • � ' .� �� ' - . _ : • alleys, locate pr000sed and all � <br /> - ' ;'� . . � .� � � � • existinq buildi:qs, show distances <br /> . , : . ' •�'"' ' ' •- "! ; . ' . .�'• . . to pro2erty lines, show dia tances <br /> .. ' �. � ' � � ' . . ' betWeen buildings. . . , <br /> . <br /> , , .• r - . ;.. . . ' r ,. 7.ot size �_x � d e <br /> .•i- ! ' • . . Lot area Sq. Ft. <br /> • r_ = . � Size of B q. ;q. Ft. <br /> � � , • Number of Stories <br /> • ' =� • i - ' 8asement <br /> !.. -�/ a �� <br /> •� ':�• ' bigned By %YCYf� � /�.1�t� <br /> . �. . , <br /> . _ . For <br /> .� . • Owner Phone <br /> � .. ' - DO NOT Si:iIT� B?LO[�7 THIS LI:IE-POR CITY USE OiIL'L ' <br /> Date Sceeived � � (� 7 S� IIse• Zone • <br /> ' Plap Check :�urSer ' ' Fire 2one ' <br /> .Valnation 'S�O- ��� Ocwoancy Grou� <br /> Pemit Fee S � �� Type of Construction <br /> Plan Check Fee � Occupant Load . <br /> . ; ibtal Fee Due rj . �v _ Sprinklers Required ' � � . <br /> � . . <br /> . Dace Issucd /O cb 7 ,_ . . • • • - <br /> , . � , . <br />