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BUILDINC PERMIT APPLICATION <br />Applicant "'o Complete Thig Form <br />� / ..J �'-' <br />C-�/° , <br />If more than �ne building is [o be constructed, submit a separate permit /� <br />application for each building. A separate pennil will be iaeucd for each <br />building. . <br />� ���' � �� i <br />Owner� �; Building Address�'���� \ C�.-,�. _ <br />Address��< � � Lot�_Block �n� � <br />`� 1 � <br />Cit}/ `; � �"��_Phene �l� , _ �? ,Subdivision (Plat) ) 0 � <br />� <br />Architect/Engineer -'�� _ <br />Contrac <br />Addr <br />Ci <br />`� Phone -t Metes & Bounds (Unplatted) <br />Sec. Twp. _Range <br />Building Use <br />State Liccnse Numbet��- ��'% �����Deacribe Work to be Done��!i C_ t��� ('('� ��<� (-'111 �)� <br />�xpira[ion Date �� ,�Cl �`I�l ��' �i�-i� ``��1,�. �� <br />�� <br />SK�TCA PLOT PLAN IILLON <br />Use of Buildir� � <br />II New 'I_"1 Addition Repair/Remodel <br />Valvation of Gonstruction 5 J��.�^�, ��C <br />PLOT PLAN F2EQUIREMENTS <br />Indicate lot size, name of streets, <br />indica[e location and width of allcy.;, <br />locate proposed and all existing � <br />buildings, show distances [o prop- <br />erty lines, s'uow distanccs Ur_[ween <br />buildings. <br />Lot size s <br />Lot arca _ <br />Size ut B19g._ <br />Numbet of stories <br />Basemert <br />Sq, Ft. <br />Sq. FC. <br />� Signed By` Datc <br />For�--�—� � 1`���Ctw <br />� t � <br />Ow^� Phonc - i � �i <br />DO NOT NRITE BF.L0�5' THIS LINE - FUit CITY USE ONLY <br />Datc Recc�.vcd <br />Plan Check Numbcr <br />Valuation r C�� <br />1 ���ho <br />Permit Fee <br />Plan Check Fee <br />Total Fee Duc <br />Da[e Issued <br />Use Zone <br />Fire Zone <br />Occupancy Group_ <br />Typc of Construttion <br />Occupant Load <br />Sprinklcrs Required_ <br />