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CITY 017 EVELE'1T <br />PERLILT' NO. <br />Dl:'.'AWIMNT 01' (:O;-INNITY DEVELOPMENT <br />!BUILDING PENUilT APPLICATION <br />VALUATION-- <br />PEIMI T Plat <br />ADDRESS OF CONST'UCT'IONWORK <br />LEGAL UESCRIrri. N: LOT %- <br />L BLOCK `,ijZ <br />p <br />rwa� Srtbtnl <br />R <br />�%GCt�lco i <br />UNPLATTED DESCRIPTION: <br />BUILDING DESCRIPTION: ITEW <br />^.DDITION <br />OCCUPANCY OR USE ice .41/ 1BMITS IN STORIES <br />IS T111S A ClIANGI; OF BUILDING OCCUPANCY: YES <br />CON'TP.ACT'OR 901"ER �XXnN <br />MAILING MAILI:NG— <br />ADDRIiSS 1iOtj,S �' sec r v: L itt e'_ ADDRESS <br />PHONE NUMBER J U ` $ 7+ �PHONE NU?iBER <br />RMODEL <br />or RI ,�z�c0 Tjtl1� <br />NO <br />CONT11,4CTOR'S Lwr,I,sL <br />— — <br />�1,1%Umu.i; <br />SIGNATURE ` � f�ciiKC�_•_� <br />- Z_ <br />NOM '111E APPLIC•',;;I' SIIALL PILL IN ALL Arnrl." DLAI tS CO?TLETIiIS INCLUDING Till'. PLOT PLAN <br />SKETCH ON REAR OF 'ilili SUEEY. THE APPLICANT IS RESPONSIBLE FOR ALI, INFOP, i1TION WIIICII <br />IS FUIZPtISIIED ON 'fill. A',MICATIOS. ANY CIIANGES It" Tli3 lNFORIMATION, PL0'1' I' J"Ii OR EUIIM11"G <br />I'ME'S SHALL BE SUI;:Il'f.rD TO TILE INSPECTIOA DIVISION FOR APPROVAL 13L u PROCEEDING <br />WITH Till, CONSTRUCTION NORK. /% <br />APPRUVA.L: � <br />I.. PLANNING, i � DATE 3-07- 7¢ <br />2. ENGINEERING <br />TRAFFIC DIVISION <br />WATER SERVVICE _ <br />SEMER SERVICE _ <br />PUBLIC SERVICE SECTION � <br />3. INSPECTIOII DEPARTMENT/ <br />4. FIRE MARSHAL <br />NOTE: ALL CONSTRUCTION WORT: SMALL COMPLY WITiI APPLICABLE CODES, NOT17S Oil Dl'.AIIINGS, AND <br />INSPECTIONS <br />