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. _ • � , _ . . DOZLDING PERMIT APPLICATION ' ' ' •. ' �. - ' �t':� — <br />� • ipplicant To Com�lete This Sorm • ''�, � <br />_ , ; . , �' ' ., ' /•� ►�:;�n <br />� � r <br />', , it more than anc buildinq is to be contructed, snbmit a separate pezmit applica- <br />�. •.� tiOa for each buildinq. 11 separate permit will be issued for each buildinq. �Y� <br />. \ � <br />�J � <br />. • �}' ao�s' � fha'7 a '; � >r I ia � 1 �� �/ Buildinq Address �� �,� 7 /% l� rir �„ A // , <br />1 : ' ' ' _, , <br />a iddress a'L'D.�a `7 t�l9t /:ni.,. ,ei/ Loe "� � �T Block �+ �/•7? . <br />. �tN � �-�'-�-�� f� Phone � �•a - �/�, > 3 S�bdivision (Plat) C F� n � � � �`// // ' . <br />_ ' ? lrchitect/Engineer � �rt f I;'j, �� ��, �, � . <br />, „ 7 �, �- ; �.� r �,t;�� <br />_':��� �°c'� City . Phone Ketes i Bounds (Unplatted) � <br />:�� Contractor //.� r4 � l r�i / l• Sec. ' � <br />� , it+p. xge <br />_' . . ;. ,,i• S3dress �� ) �� �' i � �..i.-r c, -� � . . . <br />: f ah' `) � i�, Phone ,r Ir ��, - Co 2 7 S Bnilding Ose �e= S.� . . ..',.: i. .' <br />•' � ;.. -'•:.,..; . <br />: � "`•t . . �:: : ; .. : <br />.Y.- <br />'': �'y� State. License N�nnber 2�12 0! 7�.i �> !' . Describe Work o B� Done . �}� <br />_ . �,�.� , <br />: • '.I . Lspiration Dat2 ! :� s � • I� ,_ ; ;. <br />�-1-1 (` �.� �. l c��"C � 1 si ,•� ' r�' ' . <br />� �� : •" . • SI�'TCEi PLOT PLAN BEIAW' • �� /"c�c.t, i`-�� S 7r> r i ' .' <br />;y..:� � .. ' / w � IIsa of euildinq . <br />��� . K�-�- ya:: <br />: � •. ' '. • �New ❑ Addition [�Repair/Remociel <br />. . �.i' . . � • . :' • <br />- • ; � � • - - �Valnation of Constzuction $5r•� � � " <br />e' ' .. ... :' . . <br />�- � '• � PLOT PLAN REQUIREldENTS ' <br />-.. � r . <br />� • ' . . _ - . . . a . . . ' '.t - <br />�• j ' - . . • . . . . . -. <br />. �, • Q� Indicate lot size, name of stre=ts, <br />' ��' � .: _ ' ' � ' 'indicate location and width of <br />� � ''! '�' • := • alleys, locate pronosed and all <br />'� �'�� � - . � � - ' `� existing 6uildi�gs, show distances l <br />• i.�f '` � �'`''! : : ` • '� • . to property lines, show distances <br />: ! � • . ' • betaeen buildings. ' <br />,� . ,. � �.1%�". � ' ' Lot size x ' ' - <br />: <br />•s <br />_. :: <br />?+ i <br />' ': <br />r: - <br />� •. <br />�: <br />k� • _y. , <br />` .• <br />(r. • . <br />�C-_: •;_ . g.. <br />� �' .� <br />�� <br />Date �eCcived <br />P1an.CSeck :Iurber <br />NO': Si:iITL' H5L0[J THIS <br />�' / - .�{Y, <br />Valnation � ��'�.i `�K"- <br />Peroit Fee � �� <br />Plan Check Fee <br />. � Total Fee Du <br />Datc Issued <br />e �' .�-'t� <br />.___.(. / '/ �7 � ^� <br />Lot area Sq. Ft. <br />Size of Bldq. Sq. Ft. <br />Diumbez of Stories / <br />; Basement �. �i, <br />Signed By p <br />For 12 �y <br />OWner P ne �^��� 2 52- S <br />C:lE-FOR CITY IISc Oi7LY <br />D�e Zone <br />Fire 2onc - <br />Occunancy Group <br />Type of Construction _ <br />Occupant Load <br />Sprinklers Required <br />' � ... • - <br />