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_.� BUILDZNG PER4IT APPLICATION I � / �`� <br />' � Anplicar.t To Complete This ?orm `��i� <br />.C/ �.If more than one building is to be contructed, submit a separate permit applica- <br />- tion for each building. .1 separate permit will bc issued for each building. <br />� � Owner 1:L,1�/N.�; // .�2 / '� / B 'Id' '' _^'' c- , <br />� ui ing Address , �', , �: , -� — <br />� � <br />naaress ,.�'f�j � n �" � -y f- Lot / 4' •� i! slocx � / C� �7 - . , � <br />City /-=�I�.�:'G� Phone_ � <br />�_;� � -_/-/• ��i Subdivision (Plat) <br />Architect/Engineer _,J��L �; � <br />; City Phone Metes a Dounds (Dnplatted) <br />, Contractor <br />Address <br />City Phone _ <br />. State License Number <br />- Expiration Date <br />� SRETCR PLOT PLAi7 SELOW <br />m� <br />�V <br />� <br />52c. 1;.2:. nge <br />Bvilding Use �,a C 2.c' �� <br />Describe Work to Be Done i�J i�_ <br />��7 i� i, � � <_..� � .�, d �+ � a' � � ��d <br />Use of Building �� ,r/ ��� � �� <br />� � <br />� �New ❑ Addition [�}Repair/Remodel <br />va].uation of construction $ �/,�,>„r-�; <br />,� ��I� �� <br />( <br />l��ly' �Je �'�/ . <br />/, ,w� ' � <br />'� \� � , �j " . <br />f� <br />�'�' <br />; <� . <br />' PIAT PLAN REQUIREb1ENTL' <br />Indicate lot size, name of streets, <br />ia3icate iocation and cridth of <br />� alleys, locate oroposen and all <br />; existing buildings, show distances <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />Lot area Sq. Ft. <br />Size of aldg. �� r.,�, �J Sq. Ft. <br />Number of Stories � <br />Basement _ � <br />aSi4acd 9y �:•. /�%1� " L <br />�: <br />For <br />Owner Phone _G � ] <br />GO :10: i�73?^� ���pFi -ciZ� ;,?:�c-=0R CIT'! OSc ONL'1 <br />Date ..cceised �L�--`��%� U�e Zone � <br />n,�., �:,�,:.. .,�-..,�_ <br />Va'_uatio: <br />Pexnit Fee <br />Plan Checl: Fee _ <br />Total Fee Due _ <br />Datc Issued <br />Fire Zone � �✓ <br />occuoancy Groua �f <br />Type of Construction <br />Occupant Load . <br />Sprinklers <br />C <br />