Laserfiche WebLink
BUILDING PERMIT APPLICATION <br />Applicant To Complete This =orm / <br />If more than one building is to be contructed, submit a separate permit applica- <br />tion for each building. A separate permit will be issued for each building. <br />Amer Building Address 70CD �T <br />Address %0U 't�zzTi, f �T, Lot Block <br />City �',}GFrGtPhone 2a57?--(o1S4- Subdivision (Pl.--) <br />Architect/Engineer <br />City Phone f Metes i Bounds (Unplatted) <br />Contractor Sec. J Twp. Rge 5� <br />Address <br />City <br />State. License Number <br />Expiration Date <br />of <br />Phone <br />SKETCH PLOT PLA' BELOW <br />DO NOT W:iITE BELOW THIS L <br />Date Received 7 1 <br />Plan Check Nur:ber <br />O C� <br />Valuation 2- <br />C.) <br />Permit- Fee <br />Plan Check Fee <br />Total Yee Due ' <br />Date Issued % � -7(/ <br />Building Use <br />Descril:e Work to Be Done <br />Use of Building <br />O New D'Addition ❑ Repair/Remo'-el <br />U <br />Valuation of Construction $ l��Q' _ <br />PLOT PLAN REQUIRE-SENTS <br />Indicate lot size, name of streets, <br />indicate location and width of <br />alleys, locate proposed and all <br />existing buildings, shoo distances <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size of Bldg. Sq. Ft. <br />Number of Stories _ <br />Basemen <br />i/ <br />Signed By�/� <br />r <br />For <br />Owner Phone <br />USE ONLY <br />U, a Zone <br />Fire Zono <br />Occupancy Group <br />Type of Construction <br />Occupant Load <br />Sprinklers Required <br />0 <br />,Y <br />