Laserfiche WebLink
� :_ BUILDING PEILIIT APPLICATION / � 7/ � . .": <br />� Applicant To Complete This ^or:n /c //� /�� <br />�� � <br />� If more than one building i- to be cont:ucted, submit a separat= permit aoolica- <br />tion for eact building. A sepa:rate permit will be issued for ^_ach 6uildinq. n <br />j �{' �. <br />� Owner � � r" r,.,�.; , i �, • � Building Address �y � /� `�' ��'���: _ <br />� ,� :. <br />, Address �� � i ,r,,.r-.i',i �fG�r � Lot � i Hlock <br />City ri.r�-c_<'t Phone ;; ��-' - ' ' <br />Architect/Engineer <br />, City Phone <br />Contractor .�� <br />�� ��� � N '/�: . <br />ACIaZ255 _ �i[/_ ,.-;�' .� •. <br />�__t <br />Ci.ty Phone <br />State License Nu:�iber �( 2 j Y'i% '/l �,' % <br />Expiration Date �� � ' ,' S <br />SRETC}i PLOT PLAN BELOfQ� • <br />�� I <br />� <br />.,,.I 1 I - . <br />. � �� � � <br />� r �ri � <br />It � � <br />�+� <br />� <br />F� <br />v, c\ � I <br />I\ , I <br />Subciivision (Plat) '!��; �i ,._�'- � �t �' <br />v, . ✓ <br />Metes 6 Bounds (Unplatted) <br />Sec. / ' �_n �� Rg� ,/' <br />— U L <br />Building Use % ... �,r:,_. �r.z�,�<�'y oc.., <br />/ ! <br />Describe Work to be Done � <br />= �'i�-� /,--�i" /7r'.-.. <br />� ' <br />Use of Building <br />'�Y1New � Addition ❑ Repair/Remodel <br />Valuation of Construction $ <br />FIAT PL71N RF:QUIREh1F.NTS <br />Indicate ].ot size, name of street„ <br />ind.ica�ce location anci width of <br />alleys, locate orocosed and all <br />existing buildinqs, sho�..• distarces <br />to property lines, show dis�ances <br />between buildings. <br />Lot size / 3 � x /.�..�5 <br />Lot area Sa. Ft. <br />Sizc of Bldg. Sq. Ft. <br />Number of Stories ; �--�-�r.. <br />➢asement c"i7��,.,,v _ <br />Signed 57 .-j ! '--;-: � '� -�r <br />,�' <br />� `/ '� , <br />nOL �� . l'' r /....i.<!- /- - , . <br />'Oo{nez � Pltune �;� � c>-�,:. - '.. . <br />DO •]CT . - :'i:.i :.Z21c-c'OP. CZ'i'Y fi5t� p:ILY <br />_' ,_ <br />Date ^.oceived l�� ���1 ..._�._ Uce �or.e ��-� ��ru�,��. f—ir��C.ti L.c�a'�7t7 `:, <br />� t.. t> > <br />.� <br />:'_an C:-��c�- .._-�c�_ _ tire �onc _ —' . <br />":alaation _�.�( �� Occunancy G. � y <br />Pemit Fee � <br />�4-Z"�- Type of Co�� _ � .ctior � �• . <br />Plan Checl: Fee i �b'�"� Occup�nt L, -. l� � <br />Total Fee Due 2��'� Sprinklers Required �o � <br />� Datc Issued � <br />���� `--'�L'��L�cP�Lau //-z�9"74- <br />,z f��� ��. <br />