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<br /> � D[]ILDII:C PCRI�iIT T�PPT,SCI1TYOi7 , , ,.' � �y'�,ry(.1-j
<br /> �_� .. : • . � llppli.c�nt To Compl<�tc Thi: :'orm . '. �'// ;, � �T:
<br /> • • ' SP r.azc th�n onc Uiiilctin9 is to l�c c����tructed, si:.,mit a separatc pci-mit applicz'���5
<br /> ' . , tSon £or c�ch buil�3ii�3. A sepazate permit will bc i::sucd Yor cach buildi.iiy. ,
<br /> . • 0'aner ��C �`1/ i��f:Ss� �/iCY%'� Duildin� Acldre.s -
<br /> � _ 2ddres:, .�'� jy��" LoL- � II�oc}: 7 �' S' _
<br /> . City _ Phone Subdivi_si.on (P1aL•) � v e ,- r_T/���� ]�`
<br /> ' • 1:rcttztect/�ngiriecr � _• •
<br /> _ '"� City Phone IS.tc� L L'ouuds (Unplat:ted)
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<br /> . � ;',' Cant-ractor .S�ri l�l�ia��(TLveivo,��' C r. �ec. Tcsp. l:ge — —
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<br /> .Idnress 13os"�-ir�d,s��,,, . _
<br /> •' .a.tY C'n o reTf Phone 1 J 3� ;i2 )S' "vui.lding Use � . ` '
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<br /> - � �'�� �� St%..te,Lirense tti:nbcr y2.3 - o/ -9��as' Describe S7ork to Be .Done ..��s7_v�.a_ .� �� �
<br /> : . .i Erpi.r,tio:, Dati: f' - /- 7 � ' ,�ec� Ce:J.-� � J? /� c_/�
<br /> �1 : . . ' - SCI:TCII FLOT PI.A:`i �3ELOhl� • /c�'ti/��c1�/ Tia:v . -
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<br /> , . � " U;e oE Duildirg ' _
<br /> ��' . �.1 . ' ' . . ' .'. . ' . . , ' L11tew ' I� Addition � Repair/Rctno�cl
<br /> � � '• '�. . • ' ' . . � . . � '4aluation oi Const�uction $ ' 00� `�`r �
<br /> � �� ' � � � - . . ::PSnT PL*iN P.:QUIHL"'�.::TS , .
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<br /> ' � • � • Indi_caY.e lot r..ize, n1r..� of s;xce��,
<br /> . '. � ' �i • � . � � • � � - ' " - 'indicatc locacior. �ar.d :;i.flth oP
<br /> . : � " - : . � alleps, 'locate aropo�cd a;.d a.'.1 .
<br /> �:� . . . e�:ist:i.ug Suildir.c;�, shc•.i fli�t�::ccs '
<br /> q� - � .,,- - -- •a - : � � : . : . -.S.v property linr_s, si�,cw di�tances
<br /> . : 1 . q . _ . 1�ctt.�ecn L'uilciings.
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<br /> � �.• . . .' ' 2.ot �ize x_ _
<br /> _ � • . Lot- arc,a Sq. Pt..
<br /> � k � Sia.e of fl]cg. • Sn. Ft.
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<br /> < s � • • Itw��ber of Stc+-�es
<br /> , - � � ' � P,asc:�cnt � `.--
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<br /> „ ~ ' �(a�F<�e%•'y �i ����e e� Si9ncd D� '� �_ �''�,!„�-!_
<br /> , _ J?os ;
<br /> . � Ut�ncr 7'Lone
<br /> ' . • � DO V0� SC:2I1� 9'LO!7 :'I!ic7 LT;Ii_PnR Ci7'1' ilc'i OiiL7 -- . � .
<br /> . Dzte `:eccived . ' . . � � U::e� 7.on� __ ._----_--...
<br /> � ' P].an C:�ec:: :lur..bcr . . Firc 7,onc --^--_ _._.�
<br /> l'a:uation ' Ocr.u?iancy Grou�� ____ '
<br /> . . . • 1'�:niti I•'ec _ � _ � _ `P��)ic of Conr:LrucCion � _`
<br /> I)1rm Cliccl: Tce OccuP:mC I.oad _�_,_
<br /> , � ;.c�[al Pcc lluc "—____ -- �[`:i.r.l:lcr� R�.qt:9rcri i------- .
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