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- �• • .. � •' .. . • • . ...,.. : •1 v ':�T�.� . �
<br /> s0IL0ING PERMIT APPLICATION *• '�-'�
<br /> .. , � . � ipplicant To Complete Thi:; ?orm � � , '� !' �9�,'•�f '
<br /> ' , .. 2! more than one build!.ng �.s to be contructed, submit a separate .` �
<br /> � : tlop for each buildinq. 11 separate permit will be issued for eachebuildinglica-�
<br /> • � , Arae! ��p�c'm�.� r��i,� <'A�/2 8uilding Address � ^; ,- � ��
<br /> + : ' � / �9-n/ ./r'/� �/:-if' '. . .
<br /> . a �dress ��n / ,/PR i Nf',� Lot .
<br /> . .: sixx
<br /> •�' • �tY {�%F��rL_ Phone 9ubdivision (rlat)
<br /> Y ,
<br /> ` lrchitect/Enq:neer • . — ' �
<br /> � �s'•.;` '}j �itY • Phone Ftetes i Bounds (Unplatted) ,
<br /> :," Coatractoz i � , . .
<br /> ^: ,;. ..i• 3ddress �,�.• � Sec. �_ • �e .
<br /> � �/�r• i�/ � . _
<br /> •�� «�' l�c�/- ` Phone� .;-�(2/;rl Hailding Dse . '
<br /> " . �,,
<br /> .;..} . .•;:.:: , . � . .:,,. _... . , ..
<br /> : • :jy� State Li.z.nse Nmnber �x�_,-�/./(��j'�' �scribe Work to Be Done • •.t..,
<br /> ?- L'o i/F l��/"t�L ' ..
<br /> • � '.1 Lspiration Dat� � - �� ,
<br /> . , :.
<br /> ' ;
<br /> :�: .�1 � J . . � . �� . �
<br /> _-, . ,':� , ' .81�TCFi PLOT PLAN BELOW' . • : :
<br /> ' ���-;�5� . , � IIse oE euilding 4 ,
<br /> � � �:5� n,� ` . ( ••• '.. .
<br /> . . �.; ' . . ��,-c��"-, . �i:/�� 7� �Hev ❑ Addition ❑ Repair/Rem�riel
<br /> . j a . . � ,
<br /> ' ' � ` • '• 'Valna�rton of Cnnstruction J '
<br /> � ' . S .> > • .
<br /> �. � . . � . .. .
<br /> : : � - . - . ' . , plAT PLAN REQUIREhSENTS �
<br /> � , . .'i . �. : ' � . . . a . • • , ? ,
<br /> . :a
<br /> . ' ' +. � . �". . � � .� ' • , ' ' Indicate lot size, name of streets, �
<br /> • .•f - . , -- j:,• •, � •�ndicate location and width of
<br /> . • �;.` ., , ' , �•' -• . • - :: ' alleys, locate proposed aad all
<br /> , . j +l • .:;*; .• _. .:,y . • " � �•`y ' existing buildings, show distances �
<br /> '' t • ' ' '' � � • • to property lines, show distances
<br /> � . � . • ! . • . � _, " � betKeen buildings.
<br /> - . 'v'. .'�. a . � . - ' . . �ZOt size X r '
<br /> .. . ' � , . � � . . , .. � . . . .
<br /> : • �: Lot area
<br /> �s �' , .. ' •� . , . Size of Bldg. Sq. Ft.
<br /> ' :: . i ' . • . Dlumber of Stories
<br /> r• • ' ' . • Basement
<br /> , . . .
<br /> � i' ' : . . � , Signed By . � _
<br /> • . . ' ' • � . . . ' , _ . . . .� /<
<br /> . , • ' . . , . _ For . .
<br /> .. Owner Phone
<br /> � , � DO NOT SC:2ITfi g�LGS9 THSS LINE-FOR CITY US^c Oi1L'f � � � � �
<br /> _' --. Ddte �� / .
<br /> _.�ce' •
<br /> i
<br /> ved
<br /> . . ,s
<br />� • • . II.:e 2one
<br />� ' , Plaa•CSec:; 9urber � '
<br /> • Fire Zone -
<br />( _ Valnation � S{ .� , �-� p�cvoancy Grou�
<br /> I Petait' Fee � ' Type of Construction .
<br />' • ' ' Plan Check Fee Occnpant Load ,
<br /> ' lbtal Fee Due � ' �
<br /> • � , � � � Sprinklers Required ' �
<br /> ..��..
<br /> Datc Issued ' (Q J ; , ;
<br /> • .. . _� � . .. , , . . - . . .
<br /> , . , . '. . . . � . . . , � c.'
<br /> � _ '� ' . • . , . .. � . . .'. . ' , •
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