Laserfiche WebLink
_ �� <br />AUILDIC7G PlR�fIT APPI.ICATIODI <br />Applicant To Comolete This F'orm <br />/ i� / / <br />� •%/�`j�;%'.S <br />. , <br />Ii more than one buildine is to be construct.ed, submit a separate permit ap- <br />plication for each buildi.ng. A separat� pe*mit will be issued foz each build- <br />iag. . <br />� �i �� �` $.I.�i'1 <br />� Owner �,�;, �� ,,� �i�r � L �n L�� � Duilding nddress ,S Z•'�� � <br />� <br />Address �. ='�%' L=��: ���<�'- Lot_ /O _ Blk. ��' Sec. - <br />-c--�__ <br />Citv „�;. , i,'.�n Ynone.�i.''<<�-%."�/ Twp. Rge. <br />Architect (= G! /V �� c c/; j n,�• ,� I`f+C:� ` <br />City l: I��: �77� i f Yhone_ <br />Contractor /✓� !.�l' V I iJ C.� Ht'l. J�Z�= '��� <br />Addre���� �7; Y 7E. �.. ��� � `�✓ <br />5ubdivisi.on (Plat) %^ /i / /. != ?'/+ "� r <br />Metes L 6ounds (Unplatted)_ <br />City !- ir �/? i_ i 7 Phone ..`%" i�- y-:��,!� Bui.lding Use <br />,, .. , / <br />Stai:e License Number�`�",'-•�"� -d�,'���''��.%�"';'�'/�tDe.scribc l9ork to Be Done <br />Expisation Date '/ LJ - c7 ;Z '/ � <br />ii <br />� �� � � ' ' � v/ <br />� _ <br />� <br />�/`; ��`-'! <br />_-.--�_ _ _.. <br />, _ _--.. , .'� _� � '- <br />__ ,�, <br />Use of Building�/-'i;��,�.!" /=�G�•C/�/�i'.'%� <br />'�: Piew - Addicion Repair;'Remodel <br />Valuati.on of Construction $��%.iJDi� <br />PLUT PLI�N <br />i �� �-% � <br />C, Indicate loC sizc, name of rtreets, <br />„ indicate locatiai and widtii of <br />� alleys, loc�te proposed an:. al1 <br />er.isting buildi.r.gs, show ai�tances <br />� to property li.nes, shoo� d.istance:; <br />�� bet�oeen buildings. <br />LoC size��, ,6'x �/U_/`/ <br />],ot asea _ S.P. <br />�i.ze oi IIl.dg. / -.-S C' '--S.F. <br />, Number of Stories�__ <br />, llasement_�i� /i?,� t F= _ <br />,, Use 7.onc __ _ <br />y-.Sigr.ed IIy �// - - /` � �. �: _.c' - �,.,;_.,.:�� <br />� ) � <br />cor �- ,:�.�. i , � ��, �i -- <br />Owner <br />NOT l9RITP T3EI.OW THIS ��INE-F'OR CI7'Y USP <br />Uate�Receiced � � �1 G <br />Plan Check Number • �75-[��.c7 _ <br />Valu�tion ��=( E'c�C'�- �p <br />Permi.t Pee � �Q-i ��G - <br />Plan Cl�r.ck F'ee i �l_��-' <br />Totul Fee Due <br />Per.mit NumUer <br />Dite lssued <br />Fire 'Lone _. <br />Type of Constr.uc:ion_ � ��� <br />Occupancy Group i <br />Occupant I,oad_ _ _ <br />Sprinklers Req�iirc3 <br />APPROVED FOR CWLDI�dG PERI�41i <br />D:�tey?'�/.. - �Y—�� � _—.. <br />