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<br /> , �.I , — .. . • DRZLUIRC PERCfIT TPPI.ICATIOI: . • ., • � . , �.� ,.;;, l�;j ��^� ' .
<br /> -- , .. 1 . ' : Zir�licanL- To CompleL•c 'Pl�ia Eorm . "• � ,
<br /> � .. . i . . ' ����ti
<br /> � . . ' Zf taorc tliin onc Uaildinq is to Uc contruct-ed, �ubmit n ^.'eparatc ocimit• applica- �
<br /> � . , S:ion ior c�ch buildin7. �\ separar.e permit will be i::�ved tor eaeh bui7.ding. .
<br /> ' � 6aner �� C� � Buildirg Addre�s �? 21.'� /> c �,
<br /> . ,
<br /> � � q
<br /> ' _ 1Sddre�s .2 J A� c�. � i// Lot•�_� Dlocl: __�
<br /> . ' _ City �✓Q •: e 7� P1.onc _ _ Subdiviszon (P).at) ��.. F� '
<br /> . � ' cy' . • • ,
<br /> • Lrcllitect/Engiiieer • ��✓ �
<br /> • �• '"� City Phane Ffetes L Lounds (OnplaLCed) :
<br /> ' � Cantzactot �'7'�`/L� C o ,•c' t ^ec. T`T�• n4� _—
<br /> ��• . .
<br /> ' . • ' l:ddress �`� �1 - /�21`A f S �- , 7 .
<br /> � , . �
<br /> .. j -.^�yty C�e�-c f f .Phone 3 3 v � 36 31 `�uilding Use �1 C S � . . . . :�:.o �����.
<br /> . .;�j . .�; . . . . . , . ....,.,.�;,
<br /> �� 'y:� Stzte I,icense ticnber ?L>Y_'�l-i��77j� nescribe S�7or1: to IIe .Done� .��a __,Y.�
<br /> : �,. '� i�piz.ltion Date �' -/ - 7' � ' ���a��U . �
<br /> �� � '� . SP.D1'Gi FLOT PLi.!I 9ELOF7� • . . . �
<br /> • ; , — . .
<br /> - � • • � Dse of Building '
<br /> • . :.1 . . . � . . , .. . �
<br /> • ' ' ' � � � nldc:t ❑ Addition � Rcpair/Remo��l
<br /> �. . . . . _ . , .. . .
<br /> � � � ' • • • ' � . - t*aluation oi Cnnstruction $ �a �" ' '
<br /> '�. � . . . . . . .
<br /> � .. • � ' /� ' � ::rr,or rr.rs� R.QUIRL'E:.TS . '
<br /> '* . , �¢-v.� /2a � �✓. •� Indicate lot size, ��ar.�c of �treets.
<br /> ; . . . . .
<br /> • � • � •ina�c,�� io��cion �r.a F1CL:1 0�
<br /> � � �, Cv+++�• . , ' . ` ��. . ' • alJ.cysr '7.ocatc aroposcd ard all .
<br /> ' .' : - f/, f � ' S '�:�.o�—'� S. ' er.ictin9 �uildings, she:� di::�ances
<br /> . C.' .w.Q . • 4• . . . -iu pzoperty lines, si�ow di.stanec�
<br /> • S �I " � ' - bet-wecn buildings.
<br /> - A � _ . . . .
<br /> • : .
<br /> • �. . /1�'e ..� ' � ','�.��e .,:� ' Z.ot size X
<br /> �. ' . ' � (r ; v ,k c�," . T.ot arca Sq. Pt..
<br /> � . , , 'Size of 13]dg. Sa. Pt.
<br /> ` _
<br /> :'•• � � - itmaLe: of: Stcric�
<br /> <� • •
<br /> . '.: � . ' basc:acnt --
<br /> . , , . . __c�� •
<br /> �.. ��-�v
<br /> �
<br /> — '. . Sinncd' Fsf
<br /> - Por
<br /> . . � . � . . � Owncr Yl�onc � - _
<br /> � ' - PU :i0: 1•7Z�T5 9�L0:9 TIII� LI:di:-POR �:I7'\ USi{ OIIL'1 � �
<br /> DaYC `.:�Ccived � • U�e� 7.On_ _ -.
<br /> � ' Fl�n Check :7w:bcr � � Tirc Zonc � _ _--_
<br /> � \'aluation � __ _ Ocr_uvancy Grou� �
<br /> Fcmit: Pce � _ � _ � `!'ypc of Con�;truction �� ____.___
<br /> � Plcn CI�ec1: Pcc ' _ Oceup:�.nt 7.oad
<br /> , ,Vtal T'cc lluc _ __._ � .SPrinl:lcr� R�qui.rcd � � _. .
<br /> . �� ' . . ' . . . : • .
<br /> Dzi�: 7:sucd _.__� --�� , . ' ' . . .
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