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BUILDING PLRMIT APPLICATION /���� <br /> Applicant To Complete Thia Form <br /> � <br /> If more than or.e building is to be construct.d, eubmi[ a eeparate permit �'y/S <br /> • application for each tuilding. A separate permit will be issued for each <br /> building. (� <br /> Owner�\' ��p �CU 1' L.-`F24 Building Address � r�, � "1 1 �1 �t t fl ;r <br /> c <br /> �— <br /> Address�� `�� �p���_ Lot yl..�'1�Block .�j� , <br /> -- t� <br /> i <br /> City �'�, phon -,� (e Subdivieion (Plat) ��M� �o � Ty�'� <br /> Architect/Engineer <br /> City_�_p}�one Metes & Bounds (Unplatted) <br /> Contractor�\�`�p (rQ���,b,y,k,., Sea _Twp._Range_ <br /> Addrese Jbp(n C�w.:•�.s_,,.� V,^��� <br /> _� <br /> City `�- � p}�ane��1Building Use <br /> State LicenAe Numbe�Q�_Q/-f/y2�escribe Work to be Done <br /> � , . <br /> Eapiration Date���-�� �1 ( ,� J�n � A f {,�' �J�� � <br /> SKETCH PLOT PLAN BLL01V <br /> � Uee of Building <br /> II New ❑ Addition fPRepair/Aemedel <br /> �r n <br /> Valvation of Construction $ ` 7 �, �� <br /> PLOT PLAN REQUIREMENTS <br /> Indicate lot size, name of streets, <br /> indieate location and width of alleys, <br /> � locate proposed and all existing <br /> buildinge, show diatance�t to prop- <br /> erty lines, show distances be[ween <br /> buildings, <br /> Lot eize x <br /> . ' Lot area Sq. Ft, <br /> Size of Bldg, Sq. Ft, <br /> Number oC sCories <br /> . . Basement <br /> . uignerLB " Date <br /> � Fot \._���1''��w��_ <br /> Owner Phone , - -�� <br /> DO NOT WP.7TE BELO'N THI5 LINL - FOR CITY USE ONLY <br /> i — <br /> Date Received � "j � Uere Zone <br /> Plan Checdk Number Fire Zone ' <br /> Valvation r� !�f/��1 d�� <br /> _ � /`7C3e Occupancy Group , <br /> Permit Fee � �"� . �1�, Type oE Conetruc:ion <br /> Plan Check Fr.e Jccupant Load <br /> FL� <br /> Total Fee Due � -�1� � � -� _ Sprinklers Required <br /> Date Iesued <br />