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, — ., .�r.��'t_J:•-�i� <br /> � •, ; � � . ' . . . I '. . , lOILDING PERMIT APPLZCATSON � . .' ;� ,���'' '/;•:Gj <br /> _ • • � . � �pplicant To Complete This :orm ". � '1 <br /> , •• • ' I! more than one buildinq is to be contructed, submit a separate permit a��ca-J' <br /> . , tiop for each buildin3. .1 separate permit will be issued for each buildinq. <br /> . " � O�me[ /y . �L/Y� �YJ, ��f � Euildinq Address �() 3 D -� �u c�e v : � <br /> Se� 7v} `efle <br /> ' , �ddresa 5� � C� /fa v Lot � � "3 x ' 91ock � � 4- <br /> . _� <br /> City Phone� S 9� C�9,10 SubdiVision (Plat) 1ac^�ul��� • <br /> ' • �chiiect/Enqineer ' � dcy .' �,' � r� ' —� . <br /> _ •;� . . `_*� City . Phone Netes G euunds (Vnplatted) <br /> ' ;i•. Oontractor �S' E� � � ' sec. _ swp, �tge ~ <br /> , . . . <br /> c. ;. . ' Eddress • . . , <br /> . '� Clty Phone Building Use '^•; _- � <br /> '�� �..•' , . "� ��. <br /> � '`'� � State Ltcense Na�ber Describe Work to Be Done .� � ` � . <br /> . • Y . ' . . �� , <br /> : :. �1 L:piration DatB '� �oSS c,�bn�^ °( i,,,.'� C . r'�Pna; ✓ S , <br /> :' " , • SICETCH PLOT PLA.N SELOii' • <br /> • . E� . . . ' .. . . • .. �� . • • <br /> IIse of Buildiriq <br /> / <br /> �� � � . , ' ' � , , , . � � � (]Nev ❑ Addition �'Repair/Remo�el <br /> - , Y <br /> � - '�;. � � _ - � • � � , � . � Valuation o£ Construction $ 10--i� U ' �� <br /> .� <br /> . • ', <br /> �. . :. ' • ' � � • -� • . PIAT PLAN REQUI?tE?tENTS . , ' . <br /> �. . � . . .. , . . � � . . r.: <br /> � :. � • • � ' • Indicate lot size, nane of streets, � <br /> . '. '� � . . • ' '17�dicate location and width o: _ . <br /> • : �� ' • �: , � - . ' • alleys, locate proposed ar.d all � � <br /> • �•�t � � Cxisting buildiags, show distances <br /> . i !I • ... � - -- � ; . ' . .''- � • . to property lines, show distances <br /> � � ; • � � ' _ • betveen buildings. <br /> . . � * • .• " •- ' ' F.otsize x <br /> .... � ' � • _ . Lot area Sq. Ft. <br /> . � = . Size of Bldq. Sa. Ft. <br /> �i • • Number of Stories <br /> . • :: . j � . � Basement <br /> r.. \ \ <br /> '. � � . Signed 'Y � 1..� . � _�Q L�.,�� e i— <br /> ; � . <br /> . '_ For <br /> .' , � Ownet Phone <br /> . ' DO :70: S�:tITB HcLOt9 THI� LI:IE-20R CITY USn OiIL'L � . <br /> Date �eceived Oce Zone <br /> ' Plan C:iec:: _7urSer ' ' Fare Zone " <br /> Yaluation ����� QG Occuoancy Group <br /> Pemit Fee �0. � Type of Construction <br /> Ylan Chec1: Fee Ocwpant Load <br /> , � ibtal Fee Due Sprinklers Required � <br /> Date Issucd � � ' , , _ ' <br /> • . ' - . , . <br />