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<br /> -� � -- -- _� __....___�.., �...., �� a ���,ncoc� pcianic appuca-
<br /> . ; Lian for cach buildin3. .1 separate permit will bc issucd tror eaeh buildinq.
<br /> ' " ' O�mer �c � a y d /� ./{���-t ✓; �, Buildinq Addzess � y� ����d .
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<br /> 1 . + . . �ddrese ,�7/.2 f2i✓�.r c��s -f- .
<br /> Lot ��L•�-7 Slock S�5'S'
<br /> �. • � , City ���/�� Phone 33 7-'��I3 2-Subdi4ision (Plat) � .
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<br /> ; lxehilect/Enqinee_ �cz�- .T�Gr n � n�t/ � �lE-�r�--�'T
<br /> _ •t : `_j City .Z�'dva� s'Lone a•`�%- �t�7/ Netes i Bounds (Unplatted) ' • �
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<br /> : ;�•. Coatractor �f�: /1�s»✓. o Sec. '!�p. Rqe _ .
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<br /> = �;, . �• 34ddress te.��� � . . . __ ':
<br /> . ' .Y. Citx • Phone Bnilding Ose �..��� �' u'�r:-r-'�'��. .
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<br /> •�• �:`� � S:ate License t7�ber D�.�c.:.�a W;��rk to Be Aone �"
<br /> � .'. . il Ltpizatioa DatB . _' /1��uJ ` nsa 5�.�c�'{r O�tl •. .
<br /> t�: ' . • S]CETCH PLOZ' PL�!t BELOt1' /�. w • �
<br /> . . •.-%3-s' • ' ••• , C �'1N !� . _ �_ IIse oE.Buildiriq _,U�_--- � •
<br /> -•-I-� --r---.-i-T=--. .
<br /> A� • �jie» ❑ 2ridition ❑Repair/i;e�o:Iel
<br /> �` '�. , , •: •. �,i?` , � . .j• �Valnation of Canstcuction $ /�L L; C c C 'G n
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<br /> � �} ' � �-"�'j • . . PIAT PLAN REQUl'_RE�L::TS •
<br /> ��_ : _! . • ' j'.�. . � ' . . ' � '
<br /> - . s S': `/�. . , � '�. � • �- 2ndicate lot size, nane of str.eets,
<br /> �'YiS�iii % �,� �� - � . � �
<br /> f •indicate location and w:dth uf
<br /> �[�as� • • i �.• . , ' •.-j• -r• alleys, locate proposed ar.n al.l
<br /> r'' . � , � � �'-• existing bnildinqs, sha+ distance�
<br /> . � • ,� +• .�•, /`�,I�� '� .
<br /> _ � ; . . -. �t. F. � ,� to property lines srow distar�ces
<br /> 'betveen buildings.
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<br /> . . . . •' ' .. . . � _ ��-fl, . . % � .
<br /> �� . .. , Lot sfze �'.;-o x f;�.o - c�
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<br /> - : �,4��C i.u�� . '� _
<br /> • :.t- . • . : I.ot area L�Of� Sq. Ft.
<br /> . � �.' S ,���.l� ;; .'� � . ' . Size of Bldg. t�s 5q. Ft.
<br /> ' ' �'E � . - �, ' ' Number of Stories 2
<br /> • :: . � . .. . • a" , Basement •
<br /> '�f: . � � . . `_ � . £igned C .e,4
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<br /> ' ; ��-._ � • � . ,••_� For �c. �.� L7
<br /> Owner Phone
<br /> - , �. s�i���?/ • . - • . . • . 3 3 7 - /4 3 L- .
<br /> „' � �DO NOT K:tZT� 9=L0[1 THZS LI:�E-POR CITY IIS OtiL'! ` _
<br /> : _ Date �aceived II�?�4'171� � IIce• Zone • , �
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<br /> ' Plaa C:�r_c� :7uaSer ��— �33 ' Fize 2one '
<br /> �. V,ilnation Occunancy Groap
<br /> • � I'emit Fce � ' ' Type of Constzuction '
<br /> ' Pian Check Fee � ' Occupant Load • _ _
<br /> . ibtal Fee Due Sprinklers Roquircd �
<br /> .. ' Datc Issucd • ' • . .• . . • . ' ,' . , . • . . I
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