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BUILDING PfiI2MIT APPLICATION / �j/u <br /> '; Applicant To Complete This Farm , �/��/7s <br /> ,. � <br /> lf more than one building is to be construcLed, submit a separate permit ap- <br /> plication for each building, A separate per.mit will be issued for each build- <br /> ing. <br /> O:�ner ��j p�.2i� � �.{-����� �uilding Tddress Z j L� m A P�F� � <br /> Address�� ' /�,. ��7�.1 '�,_7�� Lot� IIlk. S 03 sec. <br /> J <br /> City �I1C_��'7'r Phone Twp. Rge <br /> Architect _ ��fJ�Q� �� Subdivision (P].at) �M/LE`/ ,���/� A,, <br /> City Phone Metes & IIounds (Unplatted) <br /> Coniractor <br /> Address <br /> City Phone Huilding Use_ �f_�� �,-�,�-� <br /> � State License Number' � � ' Describe Nork to IIe Uone � <br /> Expiration Uate ���vV� <br /> . .��v` �]{�� � S( , N��j Ose of Build�ing � - <br /> i-- — <br /> � � l -�� '�New _ nddition ✓fiepair/i:enodel <br /> 'S%�i�WALK I•� valuation of constructi,on $ <br /> ---- ,. _. __._ -- <br /> "� — � PLOT PLAN . <br /> / Indicate lot size, namc of strcets, <br /> 's indicat-e location and width of <br /> . � --� ---�� M . � alleys, locate proposed and zll <br /> N � exiating buildings, show distances <br /> ' ` to property lines, sho�a �iistances <br /> S�l' ��� �... �� / ,,ii ��� I/% ! between buildings. <br /> ' LoL size SO x I71� . <br /> � � � Lot area '� «, S.r. � <br /> Size of 231dg.�� y, �Zp S.p.. � i <br /> 7��s i NumUcr of Stories � � <br /> ' �1/�1pL� � IIasement �oti` j <br /> � � . � Usc Zone <br /> � � ��L�L�--- - . Signed IIy�- .. I i <br /> For��• L� i <br /> ner � <br /> DO NOT {QRI1'Zi IIEI.OI•1 TIIIS LINE-FOR CI7'Y USI'. ONLY <br /> oate tteceived � -17-7 � Firc zone I <br /> Plan Chec1: Nuntber � 7_S' -/CD/ Type oP ConstrucLion <br /> Valuation_f�; ���n Occupnncy Group <br /> Pcrmit Fcc �'y.(7 p Occupant Load <br /> Plan Check F'ec 5�. �) n — <br /> Sprinklcrs Rec7ui.red <br /> Total Pee Uuc �/�O. O O ') — <br /> Pcrmit Nunil�cr ' - _ ' ^ / � <br /> Datc Tssucd ' ` { � � <br /> � ��� �/��,�'� <br /> � APPROV�b <br /> FOR DUILDING PCRA4IT <br /> Dale_ � <br />