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BUILDING PERMIT APPLICATION /0 71 <br />Applicant To Complete This Form # <br />If more than one building is to be contructed, submit a separate permit applica- <br />tion for each building. A separate permit will be issued for each building. <br />Owner AL-/+C.K RNGwe, Building Address 8zjl3 <br />Address Lot Block <br />i <br />City &5'47Tl.F- Phone Subdivision (Plat) <br />Architect/Engineer /t u !_ U AA,/L4 <br />City > tc ATLT LPhone Metes & Bounds (Unplatted) <br />Contractor InA5 M U-55 EI/ Sec. 1 2S Twp. 2-:�? ' Rge S <br />Address ! 701 <br />city 51 —r1,4g a-ygO Building Use (1i Es ; �'I1,axv i <br />RTiLE Phone <br />,.j State License Number Describe Work to Be Done <br />:i Expiration Date _ T 1y T 1= R70 R rZNS 5/ <br />SKETCH PLOT PLAN BELOW <br />{ <br />Use of Building <br />i 0 New ❑ Addition ❑ Repair/RemoGel <br />.Valuation of Construction $ 3 G 00 O <br />•' PLOT PLAN REQUIREMENTS <br />Indicate lot size, name of streets, <br />i indicate location and width of <br />alleys, locate proposed and all <br />existing buildings, show distances <br />! to property lines, show distances <br />a between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />• Size of Bldg. Sq. Ft. <br />Number of Stories <br />Basement <br />. , .. Signed By "`•' R.n.+ti/ / s/\,-- <br />For <br />Owner Phone <br />iDO NOT WRITE BELOW THIS LINE -FOR CITY USE ONLY <br />Date Received,-`�.��� Uce Zone <br />Plan Check Nunber <br />Valuation <br />Permit Fee <br />Plan Check Fee <br />Total Fee Due <br />Date Issued <br />Fire Zone <br />Occupancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />