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<br /> _ • .�� 'i � — . ' • 802LDZ[iC PLRHIT TPPLICATION • ., . . /�9�� 7 . ,•°' .,,�� '1 .
<br /> �' � ' , • , ]Ipplicant To Co�npletc Thia :orm ' ��r-;
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<br /> , • • ' 2! torc than onc building is to be contructed, submit a separatc perait a�plir.�-
<br /> . : ti0a far each buil�ling. .l separnte permit will be issued for each building.
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<br /> . � � Waet � �•. (�� � ,� c_ �iy�-_. Snildinq Addiess � / 1-� 1 ? �c.�_�.f���
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<br /> ,' . 1ldaress / z J- 7� ,�-�.�i�-.J Lot 3 c� slock � j �_ .
<br /> � ' , � City Lnr • ph� � Sab3ivision (Plat) � — .
<br /> ' ' Erehiteet/Enqincer � �i,�� .�L� �% �-
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<br /> •.t _ `c'� City Phone �tes & Boun;s (Unplatted)
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<br /> . �,�. Contractor � �c,.i�-a, ,�� Sec. 1t,�p. Rge . �
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<br /> _. ;. . � .l_:dzess ✓� 7C .3-o `�J ' •
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<br /> .. -Mty ��,��(�.phonc .�3 j���j- �- Z-`Suilding IIsc ' � � • `....!
<br /> _ .•`I . .'`v._=. : ;
<br /> ��� State License t7c^iber 3- y 3 -� /-�., ' Describe SPork t�IIe Do�� 2u- '�+��y�,
<br /> . . • � !��C�.�.e�.��� � �1�e � / // � • � -
<br /> : :. �I iration Dat� , �
<br /> �Li �. K�-/�l'r1n/'
<br /> ' ' �� «..� h-rr,,..�. t.._.L C:�.... ��
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<br /> � ' - SRETCF{ PLOi YI.1.?] T�ELOia' �
<br /> . _.� • . ' . , . . . � 1Tse of Suildir.g ' �
<br /> � ; . . .. ❑Neu ❑ Addi.ti en �P.epair/:es,c5el
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<br /> '�i . ' . : . . . •Valuation of Con�t_uc.:on S /-�e� o�� ' ' .
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<br /> ;,,; .. ' . . � . . ` . , :.PIAT PIv12J IL•=QU2's;':}!�:�T5 , .
<br /> ^ . - i . ' . ' � • ' Indic.:te loL si.�e, na:.e o.`. s�eet„
<br /> � ' ' � � ' ' •indicate locatioa ar.d �•id�h of
<br /> ' � � � ' _ � � . . • . - • allcys, �locate aroposed a:d all ' �
<br /> • � ','.E � � � � -- � • . � • ' .existing buildi:9s, s:o�v distances �
<br /> .. i ., - � ...'. - .- '! � : ' Y=�� ' . . -.�o property lin�s, show distar.ces ,
<br /> . ' -a � „ _ bet�:ecn buildi.:gs.
<br /> � : . - _ . .
<br /> . ., . � . ' . • . 'Y.ot size x
<br /> � ^ � � � � � . � ' � • � 7�L• arca - So: Ft.
<br /> • = � • � . . � Size of Bldg. Sa. Ft.
<br /> � ` t , ' - � Number o: Storics
<br /> • �•; • 1 � � , . • � Basetacnt
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<br /> ` '.:'_ • Signcd IIy -/ -Y
<br /> '• ' - . � .
<br /> • For •
<br /> � . ' Owner .Pltonc
<br /> � � DO AO'-' Y:Z?TL BELO[7 TIi75 LI;dB-iOft CiTY JS; 07L'! �
<br /> . , . / - .
<br /> . DY,c Seccived � Q/`� J - Use� Zone
<br /> ' Plan C:icek _7u:Se_ ' ' Tirc :.wic '
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<br /> t'aluation � /SOLM- �C Oc¢uvancy Group •
<br /> • �d ,.
<br /> Fa^iiL Fcc 7�• � '1'ype of Con.^,truction
<br /> Flan Checl; Fcc Occupant I.oad i
<br /> . � 'iotal. Pcc nuo 72 . m o „ '
<br /> _ .,rrinl:lur� RequJ.rcd � .
<br /> .. l?t:c :�.;ucd ' • • . • ' � • •
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