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<br /> . � BU2LDItiG PERl1IT APPLICATION . � �/ .
<br /> �. ' , � • � Il�plicant 'Po Completc This Sorm � � : D , . r;}
<br /> , :� ' If more than one building is to Ue contr•�cted, submiC a ceparal-e perm3�p�1ica-
<br /> . , tion for each bU11LI111�. A separ�te permit will. 6c issued tor eacli buildinq.
<br /> . � Ovaet '�i.- �. /= •� i. J/„ . I Sullding Address � ��i i ; �•��, � � �i�. .
<br /> .' • � lddress ;'� ' 2 t/�•.�. 1 . ,/� � _ LoC ! FIIocY. ' ��.(
<br /> . City i�,,,�_..,_<i' Phonc.'�'� �:i, ' ' Subdibision (Plac) �
<br /> ' - llzehiteet/Enqineer ' �!i-� �` � •
<br /> • '+ � `'� City • Phone 14etr_s S Iiovnds (Unplatted) ' •
<br /> - - . "i _
<br /> ;,•. Contzactor c%,�' - ��,r. �%�':- - Sec. 1t?p. Rgc .
<br /> _ � . . .
<br /> =• ;. . ' ?.ddress ' . ,
<br /> . �
<br /> .. ��- City Phone IInilding Use ,/� , .�!c, %�'iz:-'l=r:�y! .
<br /> �ii . . . . � , . � .. ", � , . :•,
<br /> � � �'�� �� SWte.License Ncnber �a ti ��(�'j - /Gfr,j/ Describe Work ta Bc �Done� � _•.�`���
<br /> • ; �i Ezpiration Datz l ; = ,.! . . . ,
<br /> � ��' . • SRETCH PLOT PL.FL7 IIELO?4� • _ .
<br /> �. ` ':� . . • . . . • • � Dre of IIuilding ' .
<br /> �• � . ' ' , ' � . , , �� • ]�New ❑ I�ddition Q Repair/Reno:<cl
<br /> _ : �:
<br /> � '��. � � � _ � ' � , � . • Valuatio�i of Con�tructi.. $ � � �
<br /> ; •� � . . � . ... . . . _. � . . .
<br /> �.... . - ' . . „ - - � . PIAT P7.7aN ZEQUIRE:•fE.�'TS . . ,E -
<br /> y . • • . ' � '.+•,
<br /> � � . , . . e , . ,
<br /> t . . � • . . • . • � . • ' Itldi.cate lot �i�e, na^e of rcets,
<br /> .• � . �
<br /> . �+ � - � . � ' •i,idicatc location and width'o£ , �
<br /> . � ,� f ' - '" ' ._. �.. � , - • a21 y^, locatc nr000sed a:d all � .
<br /> • :•' existing buildings, shc•.a distances
<br /> . ; t� . • ..' � - r- ;� � : . . � . . '-- • . . to property lines, show dista�ices
<br /> { ; - * Q ' _ - between buildings.
<br /> . . _ .• . . . - LoL- size `�� x .;� � ;/
<br /> . , • � •
<br /> � � _. . . � • • � � . ' • , �. Lot arca � Sq. Ft.
<br /> � r. _ , . . � � . Si2e of Bldg. / ��i !�' Sa. Ft. �
<br /> �i • • Wumbcr of Stories �.- . f�.�+:�-
<br /> • ' :: . j ' . • -. .. . . . • BasemenC � � �
<br /> i'i.. �' _ Signed IIy ,�'i� <, j�
<br /> ,..
<br /> : ,ti
<br /> ,��� � � � . • �, ' FOr � '�� ��i� -��i���f- i'i ..�.i� �Il_.- ...
<br /> . . . owncr Ptione ;t:'�� -,��H �,: . .
<br /> ' � DO :70T �i7?T� 9ELOI9 THIS LI:4E-FOR CITY IISi OiII.'I � .
<br /> . Datc `_:eccived /Ci�/ /�] ) � Dce� Zone , �
<br /> • Plan C:icc� :7ur.Ser �� - ��_��' Fire Zone �
<br /> Valuation '�.z� � � ( Occunancy Group
<br /> . . . ./ �+C .
<br /> Ycmit Fee (CJ C� . - �Typc of Construction � ,
<br /> �
<br /> Plan Cl�eck Fcc � z- �-- Occupant Load
<br /> , � Total Pr.c Duc fprin):icrs Required �
<br /> .. • . . . •
<br /> Uatc I��ucd � . • .' . -
<br /> ' ' ' .. . . .. . �' � •
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