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<br />_ ' _ ' " ' ' AOILDING PERMIT nPPf.ICATI0t4 . �, � � ' � ,(�� 1 T
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<br />- � � . , :.Rpplyc�nt To Complelc This :orm , l %,• ,
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<br />•••' 2! more than onc buildin is to bc contruct•ed, submit n c uratc � ��l' �J
<br />�. 9 s p' permit applica-
<br />.. 4ion for c�ch building. �1 separate permit will bc issued for caGi bui7.3iug. ,
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<br />, � � O�mer ��71F'S ,�%G',E}� � Bui2dinq Addre�s ��'i_�(5 %r:,'ir�;•c�r�
<br />, � . . Eddress � 7�%' �7Fx7�.� Lot /7 a'iX' ' Dlock ��/ _
<br />' ,• City �"N-i�� Phone u^ubdivision (Plat) /�iQi�//r� N,�4,q�N' ..
<br />' • Erchitcct/Enginccr �7/�sn��' + �F l'/Tv nF �i�,^l�i-.7?- • •
<br />• :�• "'� City Phone :bietes & llounds (Unplatted)
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<br />. � . ;',•. Ctmtractor _f'GiDN ��P.�9��iic'Y� /�Si Sec. R'w�i. Rge _ ..
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<br />' ;' '.` �3dress yFX` i c?CLr 9 . •
<br />' ,City ,�,��i�S; ��. Phone .¢� T-�l. O � 'Buildin Use � ;r�' ' ' .
<br />• 4 �,5�- rlT.�,i'�'il E11_:ty -:, .
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<br />�'t �� State. License ti�zaber .��3 d.' /.3 P7 5' Describe S4ork to De . Done �.r n �i�'i'.�'' .
<br />� ; : .i Ezpiration Dat� /(� _,3��-'7T' '',� ,P���vrE' � r F'r�sril��+ .
<br />. +� • � � .. SPSTCf1 PLOT PLA?i ?iELOi•7' • •r/�' F %,it4T1�'RF . -
<br />_ . ..� • . — . • , �Dse of Duilding ��'�ff.�T/YI F�f/Y '
<br />_L• � ' _�' , , : �pew ❑ riddition Q�t2epairjRemo::e1
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<br />. � ; � _ ' ' � . - Oaluation of Construction $ /�00 — ��
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<br />-�.- . . � . - :'PSAT PLNi RT'QUIRL'�f :;:TS •
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<br />.- j ' • ' �_ '; � •• • " Indicate lot size, nane ��f str._ets,
<br />� �� '' . � • • ' ` ' ' - rinc3icatc locetion �ar.d wicth o.`_
<br />• • ! �' � " � � � ' • allcys, •locatc nroposed a:.d all .
<br />. �;.=1 - . . ' �. �30��•;� ' . - .
<br />' _ .'T . . . ' ��,�.E,e:, y� . .exictin, buildir.gs. sho�r dic�_aaces
<br />. .� ' " •'';� /�. ' • • --to property lines, �how distancec
<br />, : . ' � .� 4 i. i��� % � � _ bctween buildings.
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<br />: � •. } . .' . • • S.ot size X--
<br />' •-� � � - � /'��`e� ' • � Lot area _ Sq. PL•.
<br />. = � ��.�,•• � , Size of nlr.g. � — Sa. Ft.
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<br />' �+ � ' � � t7uc�bcr of Stories �
<br />. ' :: .; , , . Basc:�ent �—
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<br />_ . '. . �/itY/F2 ��l�_F_ Si9ncd p � � .
<br />• 3'. . . • • ' T•or �-� ,f%,�` V .
<br />. .' _ �___�_� Z�. � � .. . Ownc--i�u� � %� � 3,�iTl�
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<br />' : _ - � AO N0: S�ZI'i� T��LD'.7 �Tf1I5 LI21is-�OR �:T9'X US'i. OiIL'L � . . .
<br />, Datc Seceived � � � U�c�7.one �
<br />' Plan C:�ec}: `7ur..bcr ' ' Firc Zo�c ' �
<br />Yaluation � Occunnncy Group
<br />Yc:niti Pce u_= Typc of Con.;trucCion ^
<br />Plan Cl�ed: Tee � • pccutianl• 7�oad •
<br />. : �,,�zl Fce Duc � �pri.�i]:lcr� R�:quircd ' __ .
<br />D: tc 1'scuccl • ` • • : _
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