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' ;:: � . — - ' . : � 10ZLDING PERMIT APPLICATIQN • ' .', �.iy� .. T>—�
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<br /> , , . ; , � fpplicant To Complete This :orm � •�o( ,�.�r , ,i�
<br /> ' � , • !I tore than one buildinq ia to be eontrueted, submit a se arate �j '�/�'�r
<br /> �. •• : tlo4 tor each �uildinq. 11 separake ppermit will be issued for each�buildinqlica-
<br /> • . � , � Ovote cf-Pub L� �� !�T_ � /�T T L�l� lnildinq Addres� `' � _ 4 � 1 f ` t r =�-
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<br /> • . � �ddress ZCc-`Z..� N� /Qv�l-� y� slock .
<br /> ' , . �1 atY ��"� � � �hone ��Z-��� ��_ ��ivision (Plat) :
<br /> _ ��. � �'chLtecL/Enqineer � � �
<br /> ^ �:`,;''�'� �tY • p�e ltetta i Hounds (Onplatted) � .•
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<br /> ' .:�' fbalractor j(�`r__ ' � �� . ' -
<br /> -: ;._ ..i• �fldsess . '. . �• . �e • : .
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<br /> �7 Phone ��_ Dnilding Ose _7��S���nU�'� .•:`:..:_t:.�, .
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<br /> :.':. :I�ti , itats,License Nmnber � ' Aescribe Work to Be Done l�2 ���► �-'
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<br /> :,i. rspsrattoA cata � � IeC—:7�'�//'� — �l/�f`''
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<br /> iT.ETCA PLOT PLAN HE7AW' ��� �/�lU� '
<br /> _ • ' !• �,� • , .. ' _ , . - U�� of Suild3ng . � .
<br /> .�. y� w + • •., .: 'QNnr � 1lddition Repai Remofiel
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<br /> ' � � . . - � � • • • � • • 'Valaation of Construction $ SCJZ� • " . .
<br /> + •'• . .. �. ' .. ' ' � tLOT PLAN _�
<br /> ' REQOIREFffiNTS =
<br /> � . . : . � � . . ; :{ .
<br /> •' .� • , `,-.'.. ' ' ' InQicate lot size, name of streets, �
<br /> � ' '1lfdieate location and width of
<br /> 2 . , .. . , . . . i� . alle s P P
<br /> • � .•y. , . , i: : . . .. :. .
<br /> .. i.• ,' r• � . . . . ' y , locate ro osed and all �
<br /> � �' ' • ' " ' • �� ' lxisting buildinqs, show distances
<br /> • . i � . ..�, •'-� �.~ , . :'• , °� ' - . t0 property lines, show distances
<br /> • �, i . � • � 'y . bltveen buildings. , '
<br /> . � • . � . � -. . � . � . , i
<br /> :'. ,',. . . ' ` , . . . Lot aize x �
<br /> � ..i- � s ' � . . . - .
<br /> . .. • . • Lot azea Sq. F;:.
<br /> . �' r.: .. . .. . , Size of B q. �__ sq. Ft.
<br /> = ` .. • • iumber of Stories �
<br /> 'y. ': ' � ; • . : . . 8asement
<br /> , ,_.� —
<br /> ~ . iigned 8
<br /> . .1 � ; . :: . . . !or _ Q ' C� ' '
<br /> . . .. , Owner Ph e
<br /> . � �. DO NOT St:2IT�' B?LO['7 THIS LINE-FOR CITY USE ONL'i � � � � � -
<br /> —� —' Date received �Q s � OCe Zone •
<br /> ' , Flan•C:�ecR t7urber pire 2one • .
<br /> Valoetton � S�� � � p¢cunancy Grou� ' � .
<br /> , temi,t' Fee _ �� � �� ' Type of Construction • ,
<br /> . ' ' Fl�n Check Fee Occupant Load • • .
<br /> � 1bU1 Fee Due 1 , '�U '
<br /> ' ' ' ' Sprinklers Required �
<br /> ' , .. ' �'_';_ .
<br /> ti Date Issued ' � .• ' . . ' , . .''>,
<br /> • 1 ' • : ' • , � . , . . , ' � • • . . . ::.
<br /> : • , . . , .. . ' . . .'. . , .'. . ' . '
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