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BUILDING PERMIT APPLICATION <br />Applicant To Complete This Form <br />If core than one building is to be contructed, submit a e arate <br />tion for e:ch building. A Separate s P Permit applica-.• <br />1 )) P permit will be issued for each building. <br />Omer }Lj � � - � Building Address(� <br />• Addres 14 l� LotC/ / <br />Block_ <br />City C_ Phoney Subditlision _ (Plat) �l ! �!l/inl1, C(�� . <br />' Architect E <br />- / 4inccr <br />City Phone Metes G Bounds (Unplatted) <br />:., <br />Contractor L l ski 9 l li t t n� 1� Sec. <br />c. �• Address �. Twp• Rge <br />' I \ i - <br />f City'' Phone Building Use i <br />r{ State License Number �� 7 Describe h'o ., to Be Done C ' <br />I i E=piration Datek --- <br />_ '`� • SKF,TCH PLOT PLAN BELOW <br />Ose of Building <br />_IL. QNew <br />•I' ❑ Addition Repair/Remo-�el <br />� .� •. Valuation of Construction <br />� ,'• PLOT PLA27 REQUIREIiNTS <br />d i Tnuir_ate lot size, nave of streets, i.; •, 'indicate location and width of <br />:• alleys, locate proposed and all <br />existing buildings shc:a distances <br />- - to property lines, •Show distances <br />between buildings. . <br />Lot size x <br />Lot area Sq. Ft. <br />•< <• Size of IIlag, Sq. Ft. <br />Number of Stories <br />r 1 Basement <br />.- Signrd-gym <br />For <br />- Owner Phone <br />DO NOT 11MIT1; IIELOW THIS LINE -FOR CITY USE ONLY <br />Date Received Ute Zone <br />Plan C: ec7lur.,ber <br />•Valuation <br />Permit Fee CD <br />Plan Check Fee <br />Total Fee Due <br />Date Issued <br />Fire Zone <br />Occupancy Group <br />Type Of Construction _ <br />Occupant Toad <br />Sprink]ers Required <br />