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SUILDING PERMIT APYI.ICATION <br />; Applicant To Complete Tl:is Form <br />� c <br />� � � <br />�� �/� � o� <br />� �/i/� <br />If more than one building is to bc constr�cted, submit a separate permit ap- <br />plication for each building. A separate permit will be issucd for each build- <br />ing. ����� <br />Oaner l Lh�F-�✓�I.�, �.''��''�'/ IIuilding nddress �i � 2- %li �i4/�i�:,-4/1J �t= <br />Address .3 / 2- W�/�KILYN � U%_ ?�ot /� Z IIlk.�_ Sec. <br />r <br />city ��•Il— Fhone �.> 3-696� Twp. R9e. <br />Architect <br />� SuUdivision (Plat)� �r"�o-��T'+� %�I✓ �� <br />City Phone Metes & I3ounds (Unplatted) <br />Contractors, s'�,E h�Ns7'�'cJCT! <br />�� <br />Address �7 �iDc� Vfi-�E � � � <br />City is-�iF,�'�- Phone Zs2-�%rlZ.� IIuilding Use �/iL//Cf"��S/OF.fJC�_ <br />d / � <br />State Licence Number'�Z3�J JM-DE-C-�ry� De cribe P7ork to IIe Done�}J>pj /�'Zb .. <br />Eapiration Date_/ -z-7 �T_ �' % � �Aie �'F kiST/iUii <br />�fcyJ S� /j — <br />w• +,,�R ���ti ��VE Use of IIuilding /^�£S/DE.✓C� <br />_ New - ddition Repair/Renodel <br />� `i7 Valuation of Construction $�_ <br />� , . � PLOT PL11N <br />E�n sn�x, <br />}-ItlUSf <br />I6.Y 20 <br />A� <br />idOT <br />GhafiEE �i ry <br />I <br />Date Receive9 / / <br />Plan Check !Jumber � �O`��L� <br />Valuation �r�f'1� �� <br />iJ � ,: < � <br />Permit Fce -� /'- - <br />Plan Check Pee 't^ `r� <br />Total Fee Duc _ `` <br />Pcrmit Number <br />Date Issucd <br />Indicate lot size, name of streets, <br />indi.cate locatiw� and toidth of <br />allcys, locate proposed and all <br />existiny buildin9s, show distances <br />to property lines, sho�a distances <br />between buildings. <br />�! f, <br />Lot size � a0 _X t`'1'� ' <br />-� Lot arna � � 000 S.r. <br />Size of ��,� DD �zc� S.E. <br />Number.of Stories_� <br />Aesement <br />Use 20» e � i / <br />Si9ned By�J i� L-.� I�IA/ <br />lor C L''�-Eti1[F �"�C' F_f�� <br />Owner <br />�. rmr._r.nR CITY USIi ONLY __ <br />Fire 2one � � .� � i =J/,�/`�'-''' �w=" <br />Type of: Construction <br />Occupancy Gioup <br />Occupant 1.oau <br />Sprinklers Required <br />Af PROV[D f"OR I3U!LDING PERMIT <br />D�In - <br />G� <br />