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.. __ _ _ _;-.� . . <br /> ' . ; � - � DOZLDING PERMIT APPLIC7ITION . � � 1 '^��• <br /> � ;• � • � �ppliCant To Completc This ^orm � l �/ `5 ."'� <br /> ' ��9�j,� <br /> „ _ .' I! more than one building in to be eontrueted, submit a separate permit applica- <br /> LlOn fo= eac:� buildinq. A separatr. permit will be i�sued for each building. <br /> . • Ovner 3 �=V 1�E V . C�•�-� P.uildinq Address ?��r� �t f1N A V i�= u.' iS�.ti�� <br /> ', , 1lddress 2"+ z-� ��i�r��,c�t't� Lot l 1� Block • <br /> City [c�'�'-'e'L'�T Phone �`=�t"� "3>��� 9ubdivision (Plat) '�/F�L�� v V�C- t�.� �c�<3 . - <br /> ' lrchitect/Enqineer � � <br /> `"� City Phone Netes i Bounds (Unplatted) <br /> - - �i :. � <br /> ;, Contractor �� �� .S • G�� Sec. 1t+p. Rge � <br /> .. , lddress '�� ��� W�.l'ntcrE i1U�, . . . • . <br /> ' ' Cit UL'LI,r=7T Phane Z,t•• 3�Fii Bnildin Use :�ir�c,�` 1=r7n1t�. � ' ' � <br /> � Y 4 � 1�_r:�-v , <br /> {� .. . . .�.; _ <br /> �� Etate.License Number 2? :3 t�� �54, 3'_3 Describe Work to Be Done ���_,� .;qc„�jt-�" .. <br /> • : . .1 Lzpiration Dat'� _ ' c'_C�n�Sin��cTioxl � <br /> :1 : '" . � SICETCH PLOT PLAN B£LOW' • � <br /> . . . . � • • . . � ' . . <br /> . ' . � " Cae of Building <br /> ;.1 . . . .. �� • <br /> � � � . , ' , , QNew ❑ Addition Q Repair/P.emouel <br /> ; <br /> , '' ; • : • Valuation of Construction $ �-I�CJG'K� ' <br /> • ' . • <br /> .` . '. . . . . �... ' � . . PLOT PLAN REQUIRESSENTS . <br /> '. i • • ` ' • • Indicate lot size, name of streets, y <br /> ' + • 'indicate location and width of <br /> • . f • • � alleys, locate or000sed and all - <br /> .. �' - '.,. . <br /> . • :'� : existing buildings, show distances <br /> _ , -- '! '+ to property lines, show distances <br /> - •� - betxeen buildings. <br /> ' ; , . _ . <br /> + � <br /> � ' � , ' Lot size �x /L-/ <br /> ...- ' � • . Lot area � � SF� Sq. Ft_ <br /> �, = � � •��� Size of Hldg. � � F.;� Sq. Ft. <br /> ' s �,� ..— - -- Number of Stories —rz� `E� �� <br /> . '.: - i � 8asement :'=�rc-T- <br /> i.. , <br /> `� '_ � I� Signed By � �,, ti� ' �� �— <br /> • • "� For �iG�l✓' J-��G'C c0%G/.i'f_�ri'T CC� <br /> '�AN 1�11 i�� - ner Phone a s� - 3•� � i <br /> - � DO N0: FZITS H=LOt7 TAIS LI:IE-POR CZTY USz OiILY <br /> � Date Ceceived l���� �'7\^ A��e Zone � - � <br /> ' Plan Check :Iurber 7 S-�� 7 Fize Zone 3 ' <br /> Valuation Occuaancy Grou� j <br /> Pemit Fee Type of Construction _,T ti� _ <br /> , Plan Cdeck Fee Occupant Load <br /> , � Total Fee Uue Sprinklers Required <br /> ' ' . . <br /> Date Issued • ., , , . • <br />