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__ - �---- -��-� _�_.,. /�"�� � � <br /> � <br /> If more than one building is to be contructed, submit a separate pez'mit appl a�/' <br /> tion for each Uuilding. �1 separate permit will be issued for each buildinq. <br /> � � -� �� .S/. <br /> Owner %�, {:" /�, .t-.., 1 � ,�%r'., ; � Buildinq Address �>dU ��� <br /> 1�ddress ;� "� y � — Lot J y %;i, . 3 i elock /(� <br /> City �- � ; , f't Phone Subdivision (Plat) v��rL �f •fOc f<! j7r �� <br /> � <br /> � � / / � <br /> Architect/Engineer �l��,�. /r-, ,'G. . .+/� /' �"�,( f,'� _ ( . r� c;/ �- ,+. ts �� <br /> � � City � :' r�: -.-� i��� Phone Metes 6 Bounds (Unplatted) <br /> :. , c=c��r,�J7/'--y � <br /> Contractor -�T�-_ /� %';-Y.•; _ Pec. 'tWp. Rge <br /> Address /'„:i �a '�'h`��y� __ _ <br /> City�/r, �•c a •,%i/!t� Phone 1. G ' "tJ-Y'�� � Bnilding Use �l�'S' {<�AIY�"�'�f _ � <br /> i <br /> � ' State License Number �. ) ; -G l - /�' 'i �� �: Describe Work to He Done 1 ._� � <br /> Expiration Date -�� % / � -� � .: 'r� '� J� � � � ��� " <br /> SKETCII PLOT PLF1tI BcL0i9� ' <br /> � �_ Ose of Building /T� 5{�fc,i-- � <br /> , f �L� t7 - <br /> � �New ❑ Addition ❑ Repair/Remedal <br /> , C •. <br /> Valuation of Construction $�C O�l < <br /> ' � � � . ; PIAT PLAN REQUIREh1ENTS <br /> indicate lot size, name of streets, <br /> indicate location and width of <br /> „ alleys, locate proposed and all <br /> - � . existing buildin9s, show distances <br /> � . . to prop�sty lines, show distances i <br /> � between buildings. <br /> � � Lot size / 'l y x ��� I <br /> I <br /> . . 1 � Lot area �> > �' �' � Sq. Ft. . <br /> � � Size of Bldg. � Yc' �� Sq. Ft. i <br /> � � Number o: Stories / ��� <br /> Basenent A c' , <br /> . � �_ � � <br /> � Signed r;� ��c c��" c'-s, L� �--:`��— <br /> i �. . <br /> 'rc: <br /> � � Owner Phone .y 9� - `/ �1 C / <br /> ?t f • <br /> JJ ::J: � -- - --- - -_ =-P0.'. CITY L5� O;ILY � <br /> �ate '__�_-:c� �— 9"7S u_e �one �` Z _ <br /> _1:.. C.'^ ...___ _ .. ?��lU` � Fire �onc � � - <br /> V3:ll2"^_L ( �U1 (C��l� �CCllD3:IC1 CatGL'i <br /> Pernit Fee 3 3Z �'`�� Type of Construction <br /> Plan Chec•.: Fee 2��.�� Occupant Load <br /> Total Fee Due S 3 7 6 � Sprinklers Requized <br /> DIItC Isc�:��-' . ' <br /> { <br /> � <br /> i <br /> —� — s <br />