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� <br />� � � � 10ILDING PERMIT .LCATZON � � • �''�i <br />. , � . wpplicant To Compl .a This ^orm � ��� <br />, •� 2f eore than one buildinq is to be con_ructed, submit a separate permi[ applica- . <br />tlon Lor each buildinq. A separate permit will be issued for each buildinq. <br />, . �e! _� �� _�� , Duildinq Address �� ; <br />. �"� <br />, . 3ddress ��,�' S//f1i{/fr"3� t-�y Lot nlock . <br />�tY �—�/f_�'E�T7" Phone��c� �Dj�7 S�ivision (Plat) : <br />� <br />_ �sehitect/Engineer � <br />. :, ' :..I ' ' , <br />- �( �itY Phone Metes c Bounds (Unplatted) <br />� Cmtractor L_�f�"�f//i.f1� /y >iisseC. �p. Rge . .. <br />. � � fddzess � _/X�X ,`�7-�j . , '. r <br />. - � <br />'; City L �/NG�/OOd Phone % � ! <br />� /� ' 7 �' Buildinq Use �g�, ' <br />� ."�i : •'��'�'� � .....�:�•,.'.:..:, - <br />• rj ftate. License Number (�/y�/�/it/,5�2.?3/� peacribe Work to Be Doae /iV %]f-tG .' `" <br />: � �I �piration nat� / �-,� 7� � �� �, �. ��s , <br />. ��: � � . ' SICETCH PLOT PLAN HELOfQ' � • � <br />, ' i . . , <br />, <br />:,� � D�e of Buildinq • ; <br />� � 11 . . .S . % . ` <br />• �l• •• � .. . ... �Pew ❑ �ddition Q Repair/Remoi,el. ' � <br />�'\ <br />' ' � � • . � Q ( �Valuation of Construction 5�� ' �- . <br />• p . . <br />� + ' �- . . � . . ���/�a% PLOT YLAN REQUIREFfENTS .- � . <br />� . , . IIP ' ' '.: � i <br />� . � � 3�' " • • <br />� Indicate lot size, name of sireets, � <br />. f �• � � � 'indfcate locat_on and hidth of <br />.�.� � -� ' . alleys, locate or000sed and all � <br />existing buildings, show distances <br />' �� � � -� • Lo property lines, show distances <br />' , �p� _ ' bettteen buildings. <br />as, ,� , . . <br />� • r'�r Lot size x <br />-•-- . <br />Lo! area Ft. <br />.� �• � � ' Siie of B dq. q. Ft. <br />. .: . y , <br />• ' Number of Stories <br />r„ - Basement <br />� �� Siqned Sy <br />i <br />. . . . POI !.1���� � <br />. � Ow� z Phone _}� - � ,i <br />, - W NO'f S�:2IT£ B5LOF7 THIS LINE-POR CITY USE OtIL'f <br />� Date Ceceived II�e 2one - <br />' Plan CSeck :7ur.,ber Fire Zonc - I <br />Yaluation Oceuoancy Grou� � <br />Yemit Fee Type of Construction j <br />• I <br />Plan Check Fee Occupant Load <br />. Sotal Fee Due Sprinklezs Required <br />Date Issued ' • <br />