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r <br /> r <br /> % 9� /J`� �,-_-_ <br /> _,� � <br /> BUILDING PERt4IT APPLICATION �/a� �� �� <br /> Applicant To Complete This Form <br /> � If more than one building is to be construcled, submit a separate perriit a�- <br /> plication foz each Uuildinq. A separa�c permit will be ued for each Uuild- <br /> ing. � •� ��s�7 1�.2iv� <br /> ���L� C�/c��.��� IIuilding Td�9res= — <br /> Owner �— Lot 43 �1:�. 5��.-- <br /> Address ' . � <br /> Phone Twp. Rge..-- —� "_'�rQG,EF� <br /> CitY�— _ J7'/4���V � <br /> ��EIQ G`rMT G',q�iff�� Subdivision (Plat)��--- <br /> .i� ' �5'3�Qp �'fetes 6 riounds (llnplatted) �• ���� <br /> City7'�/��'���.r Phone , �.D �G2/�S <br /> �Ol�/si�0�� /�G57' �Z��p�' o <br /> Contractor i <br /> � C.��.--�----_ <br /> Address_ r� �,l ,_ �/��� <br /> . Phone guilding Use � l�eh- — <br /> City�-- t <br /> � State License Number ZL7����5� Deccribe Plor}: tu IIe Uone.�__ � <br /> , �j�,J Eo�c/S�►dvc�_•✓ <br /> Eapiration Uatc � . . � <br /> ' � C. v. •✓ta. <br /> �� Use of 13uilding � <br /> . . � � � �✓�W' . Addition . Repair/Rer�odel <br /> � � Valuation of Constructi,on $ <br /> � � � j_ � PLOT PLIN <br /> � <br /> � <br /> � name of streets, <br /> Indicate ].ot size, <br /> � 5 � indicaLe location and �.�id.h of <br /> � alleys, '_ocate proposed and all <br /> �� � existin9 Uuildinys, show distances <br /> � - � to property lines, shoH• distances <br /> '� �. betwecn buildings. <br /> ,� N vi r.oe ��z�G�_X /LS S.F. � <br /> � �� � � Lot area � ----S.F. i � <br /> Size of lll.dg. . I <br /> � Number of SCories � <br /> IIasement <br /> \ /�^5; D TL 1 l��. Usc Zone � � �. <br /> " <br /> v� , - Si.yned B • � <br /> L'OY � <br /> Owner <br /> 1 <br /> DO WOT WRITP 23L'LOW '.CllIS LINE-FOR CITY USC O?1LY � <br /> � Cire Zone 3 ' <br /> Datc Receivcd �'_' L��7 S - <br /> Type of Construction � N <br /> Plan Check Number � — _ <br /> � Occupancy Group T <br /> Valuation V� - . <br /> � 3 (P Gccupane Load <br /> Permit I'ce — . — <br /> Plan Check Fce (L� Sprinklcrs Rcqui.red <br /> � Tot�il 1'ce Uuc �l ��- ~ <br /> � Permit Numbcr �--- � <br /> > 7 <br /> naC�: Is�ucd -- , . <br /> APPROV[D 10R [3UILUING PCRMIT � i <br /> Dalr - <br />