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. •.. <br />• � ; � - BpILDING PERMIT AFPLICATION ' r� i� •�.j <br />_' • • . 1lpplicant To Complete This _ orn / ��/ �'S � <br />; � If more than one building is to he contructed, subm:t a separate permit applic%/ ' <br />.. tion for each tuilning. �l separate permit will be issued for each building. <br />�'aner 1��1M. �• �ULT�� Buildinq Address 'a2 �'� MCt�o�,Lr��_ <br />, Mdress �,� I'� ✓V� ( p, u �: A � Lot Block ' <br />. City r U�- if C i T Phone�,. i-� "":�1 SubdiLision (Plat) <br />' Architect/Enqineer ��Lr`�iJ � ' <br />_ • '• ''_f City L J;= �f ;_ r ` phone _ - ? � 7p Metes G Bounds (Unplatted) : <br />, Contractor {-~U 1���/� Sec. Rt�p• Rge <br />. . � llddre�s '; /1 /✓7 :- . • . <br />' ' ' � <br />�' City ' . : L� .F Phone �/{M i� Building Use a ✓/!?o = :`:•:_�• <br />� ����� State License Na�er �� Poscribe Kork to IIe t'one ��'�� <br />• � � �i Ezpization Dat� /4J�n ( JNS"r'/1 �� T �� /l1? /� (a `" _ <br />:� ' � � SRETCH PLOT PL.1N 9ELOT+T � -- <br />. : .� ' • . . <br />i IIse of Huilding <br />�. � 1 I ' I . • :' , , • , L�New ❑ Addition ❑ Repair/Remo:<el <br />' ' � i _ � �%. � ,Valuation of Construction $ ���7• / ��'�" <br />� I � � • PIAT PLAN REQUZREAL�'.NTS - � � <br />�...- - ' . � . . <br />+ I' <br />� -- <br />i a • <br />'' ;•V � -- ' IDdicatc lot size, name of streets, <br />' '-� � 3�� �'�indicate loca:ion and width of <br />. , ! � � � � • �� �:. alleys, locate oroposed a,^.d all � - <br />�•j� � _ � : -�o �� � �� existing buildir.qs, show distances <br />j �- t�° ' '�•• v '��. `j. � to property lines, show distances <br />�n v � between b��ildings. <br />� �------' .. � v Lot sizc x <br />. } , �� . '' I . C <br />�- r � .Lot area Sq. Ft. <br />, i�? • U .�p Size of Bldg. Sa. Ft. <br />� ' �� _�--- �I Nunber of Stories <br />; , �� - _ <br />_ � - �-; i _ i , - I � Basement <br />*��: ' �I ; I,Signed By <br />� . '. � For <br />Owner Phone <br />� DO :70T C::iIT : HEi0h7 THI� LI:dr'.-FOR CZTY USS 02IL7 <br />• . r, ,' . • � . <br />Date Seceived i '�`�-' /r. U�e�Zon• .. <br />' Plan C:uck :7ur.,ber � " Fire 2one ' <br />Valuation Occuoancy Grou� <br />Pemit Fee �`�' � 4ype of Construction <br />Plan Check Fee /�.� Occupant Load <br />. � . <br />Total Fee Due ��� _ Sprinklers Required <br />Datc Issued • • , . • - <br />0 <br />