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� OUILDING PERPfIT APPLICATION <br /> Applicant To Con?lete This Form <br /> IL more than one building is to be constructed, submit a separate permit ap- <br /> plication for each building. A separate permiC will be issued for each build- <br /> ing. , ' . <br /> Owner � . (> > �j_ �t�, �(�> /� � Suilding nddress `Y7�,�j (:;��pN /;�•,�I�� <br /> naaress�� � ,)., b'�.� p�t � • Lot �J t31k. � sec. 3/ <br /> cirv �=t�' E �:C. TI� _ Phone .z.�.1�Z�,� 3 �w,y. 029 xge. ,�j� <br /> Architect Subdivision (Plat) �/�„L/� �j�n�] <br /> City Phone Metes � [iounds (Unplatted) <br /> ' Contractor <br /> Address <br /> City . Phone _ Building Use 6',a/,�qc,F 9-.E�a�p#� <br /> State License Number_ Describe Nork to De Done ��[7i1.�?__ � <br /> E>:pi.rati.on Datc <br /> \ Usc of Building��� /�,�., <br /> . New Addition Repair/P.enodcl <br /> . � � � � Valuation of Cunsiruction $ �.sn U <br /> �� - PLOT YI,AH <br /> ', . Lidicatc lot size, name of street„ <br /> • indicatc locaCion anci H•idth of <br /> alleys, locate proposed and al.] <br /> existing bui.2din9s, show distancec <br /> ' � to property lines, show distanccs <br /> �. . between buildinys. <br /> � LoL sizc .r. <br /> . . .' � Lot area S.F. <br /> � Size of I11d9. S.P. <br /> ' NumUer of. Storics <br /> .` � Jascment <br /> Use 2ouc <br /> � Si.gned llY�_6+--"e-�s��7 <br /> . . FOT—�6C�L_� ��KPx•�— <br /> O�oner <br /> PO NOT l9RIR'E IIEI.Oli 'f71I5 LINli-FOR CITY USL' ONLY <br /> , Uatr�Gc�c��i.vcd �c�/D �7 S �� I'ire Zone 3 <br /> Pl.�n Chrck Numt�ci' � —�-- Type of Constructiw: T[ _�,.,r <br /> Valua�ior. � �i`� � `� ` Occupancy Group <br /> ---��1 '-- -- <br /> Permit i'ee /(� � � Occu�ant I.oad '— <br /> ' Plan Check F'ee 5�-rin}:lers Required <br /> � G� — <br /> 7'otal Pae Duc ��. _ _ • <br /> Pcnnit Nu�nber - <br /> i <br /> D:iCc I:;c:ucd /Z/�O 7 � _____ <br /> �— <br /> nrFr,ovrn ror, ru�i.r�irac PCai�uT <br /> n.u��12J�o �.�_ _�,,_ LL_c==-- <br />