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DUILUI�'G PERMIT APPLICATION / / / ���5 <br />Applicant To CompleCe This Porm <br />i.��� /� � <br />If more than one building is to be constructed, submit a separate permit ap- <br />plication for each bu_lding. A separate permit will be issued for each build- <br />ing. � i ' � /i'� �f-8z���SP:R{� Lu. <br />Owner �.�•t+�' i /) � /�/ (� � �yj Duilding Address-� � ? )�<> �"il (" _ /' �ii' <br />Address �(�'Z ���, /%; yy__�rr �� ` Lot ��� 131Y.. Sec. <br />City. .-r��f' ��1 �D � Phone_ Twp. Rge. <br />]lrchitect � Subdivision (Plat)�� � 11'' � 'y�"� �,�.'�'� <br />C�ty Yhone j, Metes G Rounds (Unplatted) <br />� i i"' ! — <br />Contr.actor i (��! �7(/.' (' U/3. //�. � <br />nddress!'��G� � '� .��71'-f _i� ��-� <br />../ � � -�, , $S 3, 7�1 ' / <br />City _� �" t' / :.,� . .� Phone'�'_�y- � `� � � fluilding Use � � � K' ? � �. �- <br />State License Number ��°��- ���- J��� Describe t9ork to De Donc 1j < i �� <br />Exp3ratiai Da <br />� i/ .r : f-� --- <br />Use of dui <br />�ew Addition Rq�,air/Reme�el <br />/ ��% �.�, !:� <br />Valuation of Construction � <br />PLU� PLAN <br />Indicate lot si.zr, »��� of strcets, <br />i.ndicaCc location and widtli of <br />r�llcys, ].ocate proposad and al' <br />cristi.ng buildin9s, show di.stances <br />to preperty lincs, ehow distances <br />between buil.dings. <br />LoL size x <br />Lot aYca S.F. <br />Size of- Illdg. S.F. <br />Numbex of Storics � <br />DasemenC ) i' <br />Usc 'l.011i? / . <br />� / <br />Signed Dy. � � /C,. �� � % �.,.1� <br />Por <br />Owner <br />DO NOT C11;I5'I: bl>IAh� 1'IiIS I,IHli-POR CITY US}i ONLY <br />Date�P.eceived ' Z'I (_[ ��] � � Pirc Zore _ <br />Ylun Check t7umUe��-- Type of ConsCruction <br />Valva"t-ion �_ � ��J -�' _ Occupancy Group <br />Permit Pee_ �Z_�- ���'' Occupant Load <br />Plan Check Pce Sprinklers Required <br />Total Pee Uuc � 4-_ CTCi <br />Ycrmit t7umbcr <br />D.ICc I�suCd (2.��Co �`7 \� . <br />nPPRov�4 rort uuu_oirac r�[rtr��ir <br />, <br />v-- <br />