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• 7 BUILDING PERMIT APPLICATION n c • <br /> Applicant To Complete This 4orm <br /> If more than one building is to be contructed, submit a separate permit applicb <br /> ticn for each building. A separate permit will be issued for each building. <br /> Omer Building Address S�U ay <br /> Awress 510 Lon f-i- Lot7B,9 yt 10 Block Z <br /> / <br /> city CE T Phone Subdivision (Plat) C�" �*WyLn(sct <br /> Architect/Engineer - <br /> • 1 ! city Phone — Metes i Bounds (Unplatted) <br /> i . <br /> Contractor-`� j-LA,w Sec. Twp. Rge <br /> Address �7p�� YL_rt-icwil�E <br /> City phone Building Use GE .: , <br /> State License Number Describe Work to Be Dane <br /> 1 Expiration Date OtrF <br /> SKETCH PLOT PLAN BELOW' <br /> Use of Building <br /> L New El-Addition Repair/Remodel <br /> t , <br /> •Valuation of Construction <br /> �. PLOT PLAN REOUTAEMENTR <br /> t Indicate lot size, name of streets, <br /> i indicate location and width of <br /> 1 alleys, locate proposed and all <br /> ;•� existing buildings, show distances <br /> r to property lines, show distances <br /> a between buildings. <br /> Lot size x <br /> Lot area Sq. Ft. <br /> Size of Bldg <br /> Sq. Ft <br /> .� Number of Storie's <br /> Basemnnt <br /> Signed By <br /> For <br /> Qunet--) Phone ?-2- <br /> DO <br /> 1DO NO': W.RrTL B°LOW THIS LINE-FOR CITY USE ONLY <br /> Date Received Z j 7 5 ULe Zone _ <br /> Plan Check :lunber Fire Zone <br /> Valuation elo S?=0- �d _ Occupancy Group <br /> Permit Fee Type of Construction <br /> Plan Check Fee — Occupant Load <br /> Total Fee Due `j O U Sprinklers Required <br /> Date Issued Y-/� <br />