Laserfiche WebLink
• <br />BUILDING PERMIT <br />APPLICATION <br />'- <br />Applicant To Complete <br />This :orm / <br />%/// f%S ? <br />If more than one building is to be contructed, <br />submit a separate permit applica- <br />tion for each building. A separate permit <br />will be issued foreach building., <br />Ownez � �i/ / N6// /� e-/ Iv% <br />Building Address !� ��'�% <br />• <br />ff <br />Address�ldJf•�O-v n--[?_re FDi,/ <br />Lot _ Block ' <br />Cityj Phone - <br /><.'SUu'b�livision (Pla ) <br />J 5 7i <br />Architect/Engineer. <br />(//Etd <br />City Phone <br />Metes a Bounds (Unplatted) <br />. <br />Contractor 11�17/r/ ��yr ` <br />Sec. Twp. Rge <br />' <br />Address � 4/V/��• Y /�1/' <br />City L (/Pry lV Phone �3.3-i3°J <br />Building Use <br />State License Number .;�Z:5_ c7/l-�j�] Describe Be Done � Y` aLJ/� <br />.; <br />/Work <br />'/to <br />� / /�� <br />N i�Jrs-r- - OT /Vis c. <br />Expiration Date _ <br />w l� /L�-r <br />�'� r� 01. � •� G•u.•..y tYN0/0-.1 iY+�er <br />•1' <br />SKETCH PLOT PLAN BELOW, <br />.t_ 41_ <br />' <br />Use of Building <br />i <br />.. <br />❑New ❑ Addition Repair/Remodel <br />_ <br />Valuation of Construction $ <br />- - - <br />FIAT PLAIT REQUIREMENTS , <br />,,,•,- <br />' <br />Indicate lot size, name of streets, <br />' <br />indicate location and width of <br />1 <br />alleys, locate proposed and all - <br />:-'; <br />_• _ <br />existing buildings, show distances <br />�•� <br />- --•� - <br />to prop^-rty lines, show distances <br />_ <br />- <br />between buildings. <br />Lot size x <br />.•- <br />Lot area Sq. Ft. <br />Size of Bldg- So. Ft. <br />, <br />_ <br />Nmnber of Stories <br />y <br />Basement <br />'� •:.� <br />Signed By _ <br />For <br />Owner !,one <br />DO NOT ?•:aI'L£ BELOW THIS LINE -FOR CITY USE ONLY <br />Date Eoccived - <br />ULe Zone <br />Plan Check aur..ber _ <br />Fire Zone ' <br />Valuation - ( �� <br />Occupancy Grcup <br />Permit Fee <br />Type of Construction <br />Plan Check Fee <br />Occupant Load <br /><� <br />Total Fee Due \^, <br />Sprinklers Required <br />Date Issued J <br />- <br />