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-- . I — . • II[tir.n*wc rr.ai��z�t nrrr.ICAT70ia • . . , ��"p• • .Y - -
<br /> .. .' ' . . � Applica�it 1'o Co:nplcLc Thi� :'orm , • /• / � �Q�:t
<br /> ; � . . , �.����� j_.
<br /> , • • Zf taorc than onc Uui]d'zng is to l.�c contructcd, si�bmit a deparatc pcir.iit applicn-
<br /> i'ion for cach buildi::7. ,� separatc pezroit will bc i::�ucd Lor cach buil3ing.
<br /> , " � 6.tner � �;'�'�� . '� �� � `' - 3,i Zff
<br /> ,��_�': l: • /' Building ncldreca 'S (%
<br /> . • •i ' . . _ " .
<br /> . Pildres� !
<br /> . LoC Bloch
<br /> ' . City ^^ � _ Pitone Subdivzsion (Pla�) � :
<br /> . �
<br /> _ • L�rchitcct/�n.giticcr C�.C�:y%�..�.v-,��� . .
<br /> ' :..I �'` ..� ; ' v , _ — —
<br /> _ _ ._� City 4��/,� `���.- ]yhone 2S 9-��/.5 .Pi��tes L L>ounds (Unplatted) ' .
<br /> - :,'. G�niractor C��-cc�vvw�L� � �/�C'i; . .^,eC. iwp. Rgc
<br /> ' 1:P�8res� /` Y�� �c'Ilrz� ;i �> '3 ' ' •
<br /> • ` -,7 , �/ •
<br /> . ' -.City/�/1�tiu��wtC(� Phonc L�J �� 7� � i "Bui.lding t7se ���i:.�; i«� ���fi�Z`^ �
<br /> _ "-.� ' / �;' , :. .
<br /> '•;� ' State.License t]cr..ber " ;';j `.��/-.,y`%i / (; Describe Hork to IIe .Done r ' � ^�''
<br /> v.--���r.l��-�t�._
<br /> : � � .i �:Piration DaC� y -/� -� � �� , v � . � .
<br /> �� �/i^'-ta�=,�. /L:_-_n �n,ui � ���n
<br /> _ � . . / •� . � ( �
<br /> � �t ' �� , • SI:I;1'Cli PL'OT P7.Ati 9ELOi9' • "
<br /> - -'' � —
<br /> I . .
<br /> . :.i . . ' • . _ - ' Dc.e of. Buildi^g CE'.7wi�-1�z(��� '
<br /> i-Ca,_.(e,
<br /> _°' � • . . � , � . : ' �]I:ec�t � ❑ 1ldditzon [�5(Repair/Remo:iel �
<br /> • .. . � . - • . . :` . - .
<br /> • � i . � � � � � . . • - L*aluation �t Construction $ti�0� , - •
<br /> � , '
<br /> • '� ' � . . ^ -:P1AT PLIS!d ILQUI?tF�"E,7TS
<br /> �y . . , . . ,. . , ,
<br /> w . ' . . . � � . . '
<br /> , ' ' ' • ' Indicate lot aize, nane of. street^,
<br /> � ' ' ' -.£ndicatc location zr.d ;:i.cth o�
<br /> . � ..7 - � '_ . ' .: � . � al).c;�s. 'locntc oropo�ed ar.d a'_1 '
<br /> .. � -1 ' _ ...- . - - . . . . . - . � .cr.i::t:ing huildiags, shce: �'is`-�••cs . .
<br /> �_�.._
<br /> . i; `9 . _ � • . - -io proper�y lines, si;ow di.star.ces
<br /> . _ � A � ' bCitrecn liuiltiings.
<br />� t • t : a� ' : : - Lot size a - .
<br />� ' •: . � . . . � ' . . TOL 1IC�7 ' Jt�• rL'_
<br /> •. .:. . �Sizc of !31cg. Sa. E't.
<br />, ` ' . ' • Iiwnber of 5tcr.ir.s
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<br /> . . • L'i15C:�!_'Ilt �
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<br /> ._- � ��i•,_ CL �' / /�
<br />� � _ � � � � Si ned B ���/L�'- � —
<br /> • . 9 Y ��r� v'�_.,r7L,;�J-�-t � ��i,r i_-.
<br /> . . . . . � � - / �
<br /> ' - , • � � Por '���.�,ti s-�.��� �L-k_e , � '
<br /> . . . . . . ' U�- eZ PLonc
<br /> ' � PO VOP StiZ?T' 9:T.O�I i1iI� T.I']ii-P02 Ci.7'Y USi: OiII�'L � . .
<br /> : _ Dzte S:eccived � � S'� Uce 7.one '
<br />� ' Plan Chec,; t.ucber ' ' Fire 7.o�e '
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<br /> . . �a:uat.ion '^ ¢�ODD O_ occunancy Gcou� -----
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<br /> Fcn7iti Fce ���� � _ 'P�pc o; Construc�ion
<br /> — �= , - -----
<br /> Pl.,n Cli�cl: 1.'c,c _ /�� . � Occuper.t I�GA.'I �.
<br /> . . S�tal l:'cc uue _Z `/� 3 ,'7 O `_ ;;��ri.nl:lcr� I2ailul�I'.r.:l „_-,�_____ --_
<br /> b:.te :[:.:ucd ----- ^, • � � . . - '
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