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, ! � . - ,.� ' . .- lOILDSNG PERlIIT APPLIGTZON . � !�/, ���'•. <br /> �- ' .� • ' � , � applieant To Complete This 'orm • �� �/1 � <br /> � • . . . ���/3 <br /> ' • ' Ii �ore than one buildinq ie to be contrueted, submit a separate permit applica- <br /> tlaa for each buildinq. A separate permit will be iasued for each buildinq. <br /> . ; ' o�n.r - �i//i.�t+H iit/. �d�Nc/fr.uOh'T'� luildinq 1lddress '�G 3i cvcrr�io.rc' <br /> � <br /> . ' . . bdress / ��u S �/�ii'u1� fi�'tlC N° Lot Dlock � • <br /> City �Se'�n� Phone G/ -(o��57 subdivision (Plai) � <br /> � � >rchltect/Enqineer � • <br /> • `a � .`_'i City Phone ltetes i eounds (Unplatted) <br /> - 1 ' <br /> .�' CmLLaCtoL � SK. 'lY/p. Ry� ' <br /> ' , ,. � �ddress . ' . � <br /> _ _ ' <br /> ! Citp Photte �uildinq Use /1'J[.!/=PLr'�' fr��,��:',.-:. <br /> �:�.i �..: . . � . • - . <br /> •� '�� f4te,License Number Describe Work to Be Dona /s�'�.�. ' Y <br /> � . : .t L�iratioa Dat� �}o,�f-Ns3 - -'r,-•Y�-�r �l+�_�: <br /> `1: � ." ' . , . /.uST�lG a.._ p <br /> � ZLETCH PLOT PLAN BELOW' � ff�et Rar.0 �o � <br /> U �/u <br /> ' .� - i . " • oN i • 1` �� . �h� <br /> . ' : � �: ose ot suiiatny R�sr �C'ovm. ' <br /> � .. - . . . . ' ' �ltw 0 l�ddition ,�Repair/Remociel <br /> �� 'Valnatien of Construction 5 RS��'O% � <br /> . : . . <br /> .�. � � � . . � ' � . - . lIAT PLAf7 EEQOIREMENTS . <br /> .�, . . - . . . . . .._ ' � . . . <br /> � � <br /> '_ ( . • '` ' � - Indieate lot size, nane of streets, ` <br /> . " " � �'; ,: - `' �indicate location and width of <br /> . � � � - . ' alleys, locate proposed and all , <br /> . • �- ' �' . ' l�tistinq buildinqs, show distances <br /> _ _ � '� ' - -- ! • : ` ..�`• . -. . to property lines, show distances <br /> ' � Detveea buildings. <br /> . t .. . : • � Lot dze z <br /> -..- ` • . Lot uea _ Sq. Ft. <br /> �, - • Size of B q. Sq. Ft. <br /> ' i , . lfumber of Stories <br /> _ '.: . i . �asement <br /> r.. _ — <br /> ,_ _.._- �iqned By . <br /> i <br /> `ror <br /> - ' - � � " - � Owner Phone <br /> � - DO NO� S�ZITS B�:.OIa TH25 LI:IE-FOR CITY USz ONLY <br /> .. --Date ��ceived Q-J'-'.r, �-7 1 " Atc Zone <br /> ' �Plan Check :Jurber ' Fire Zone ' <br /> 9alnation `�' `� '-� ` �-J Occuoancy Group <br /> hmit Fee — Type of Constsuction <br /> .�. llan Check Fee �-� Oecupant Load <br /> � <br /> ' Sotal Fee Due �U` ' �y— Sprinklers Required <br /> ' Dace tssuea 4�30/`7 5 • ' . , _ • . . <br /> , . <br />