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� Applicar.t 'co Cr..ptotc 'ints �.on�� �� �✓ �/
<br /> If more than onc buildinq is to bc contructed, subnit � separatc permit applica-`/S �
<br /> tion for eac jbuilding. A seeafate pecmit aill be issued for wcl� buil�i?^� �
<br /> Oirncr �jRN���/L � /�bi2.��"S��T/ Building Address y,j �_j � �� j
<br /> Address �,5 O� / J TIJ�• Lot I Slock / __
<br /> � �
<br /> City .�_ PhonC_ �'�`.' � r ;
<br /> .�,.lv OT Subdi�•ision (Plat) /1�-
<br /> Architect/Enginccr ���� _ i0�_/�� /i��i 'r'� � _ __ �
<br /> City Phonc Metes 6 IIounds (Unplatted) _ �
<br /> Contractor /y/f Sec. 'R+p. Rge �
<br /> Address �
<br /> i
<br /> City Phonc Building Use _J"c, j� . _ ___. __
<br /> State License Namber De�crite korY, to Be Dom., �pp 7j�-J !
<br /> �.� ' /�.,,.1_ r ws)
<br /> Expiration Datc ,�,iii' !'/„+;��/'f'�`' /] �
<br /> St:E'CC❑ P1�-^T FLi,,� r,Ci.�,. _.�� Lit• � . ' � �/ r✓ � . .� I
<br /> —__—_—.—_—. . , i
<br /> Use of Buildinn r'9�/'.9cY%` ,
<br /> ❑New ❑ Addition ❑ Rcpair/Fcr..ccc1
<br /> w��o��./�4;�,���� ,r6 '
<br /> Valuation of Con� ructicn :;_� __
<br /> . F'L,OT PI.AN P,EQUIRr•.1L::TS . �
<br /> lncicatc lot si�c, namc ot .,trec_^,
<br /> indicate location anZ w:�th cr
<br /> alleys, locate aropo=ed �nd �'_!
<br /> existing buildi�as, snow distances
<br /> • . to proncr:y li^es, show dLs[znccs
<br /> .. bct�.•cen buildinas.
<br /> / /
<br /> :.ot size �� x1�� __
<br /> Lot area � Sa. :_.
<br /> � Size of Blag.% 2 y/) `4• =- •
<br /> " \unber of Stor:es _p V
<br /> °a�cr.�;;� /) '
<br /> ::iccc:: 9y �/ ��.L':.�;'- - --- ._ .
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<br /> �i� �� ! _�__,
<br /> Fc: _ ' s�;��;!r_,.� � ' -
<br /> � C.:ncr ,,•:nonc ��,;• i/�. -' .
<br /> pp ::IT' :-ii -�nc I,]'. -- CITy per p;- _
<br /> -,---------- -�r - �J- ---=-- u. � :��., �/ �iNv� �a—�r,�
<br /> . �-. .,-.�� . ....-r.,- e�r� zo�� �3 _
<br /> Valuation Occuoanc•,• Gco•.:_� _. ..
<br /> Fernit Fce. Typc c: Construetion __
<br /> Ptan Checl: Fee Occupanc Lo�d _
<br /> Tb[�1 Fec ^c^ Sprinklcrs Required _
<br /> Dat�� I�.:-.u,�d ('�.� ' � . . . ' � .
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<br /> , . i� ,.. .i., � . .
<br /> `�. �:���✓ Z'4-��J� �
<br /> v�awonac� �.v..�w�o 2-a���e��. ,"; , � ,�,� ;a��._ �«a,��
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