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�� � � � � �pplicantVToyCompleteyThis�?orm � � .''j <br />_ . • . � % �' ��Z <br />, ! more than one building ie to be contructed, submit a separate permit app a-.,/ <br />,, tion for each building. A separate permit will be issved for each building f�� �/�% / <br />'� �'t Ovner / .� � � � ' ,_ Huildinq Address � : <br />� , Mdrens " Lot/l! �, � Hlock � <br />City t' ,�. , ,•.s> Phone ' Subdivision (Plat) � <br />' • ltchitect/Engineer � � <br />""+ City Phone hetes i B;unds (Unplatted) <br />- - 'i - <br />, Contractor � Sec. 7Wp. Rge � <br />. > >ddress ' ' • <br />' City Phone Buildinq Use =�;.`;;�„ <br />.. 4. . '.r` . . "i <br />-•� �"j � State License Number Describe Work to Be Done ��;�.,.-( �''���. <br />Y <br />� • ,i ' Lnpisation Dat� � ;� ..� . <br />>>' " � � SICETCH PLOT PLAf] BELOfP� • � � <br />. ' :{ � : � IIse of Building � <br />♦ � : . ' , , _ , � ❑New ❑ Additi� n � Repair/Remoiel <br />,� ' . . . 'paluation of Construction 5 � <br />v. �� � . .. -^ PLOT PLAN RE UI 1 �TS - <br />.,, <br />• ' <br />• � i <br />. 1 <br />_ . ..� ' <br />. � <br />r.. - <br />.; <br />. : i. <br />.:. ' _ <br />.' ,: -- <br />. ; <br />N <br />. Q R&IE. _ <br />�- Iadicate lot size, nane of streets, <br />� 'indicate location and width o: <br />� alleys, locate nruoosed a,^.d all � <br />. existing buildings, show distances <br />. to property lines, show distances <br />betveen buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size of Bldq. Sa. Ft. <br />Nwnber of 5tories )— <br />Basement / <br />i Signed Sy % ( <br />Por ' � <br />Owner Phone !� �� . - <br />DO NO': 5�::2ZT� B=:OC7 THZS LINE-FOR CITY USE 027LY <br />Date Seceived Ace 2one <br />' Plan Chec� :tur..Ser � � Fire 2one ' <br />Yaluaiion Occuvancy Croup <br />Pemit Fee Type of Construction <br />Ylan Check Fee Occupant Load <br />' Sbtal Fee Due Sprinklers Required <br />Date Issucd <br />.l �� ' �r . ' � ' ' <br />