Laserfiche WebLink
llpplicant To Complete This corm /p P1 <br />• If more than one buildinq is to be contructed, submit a separate permit pp ica- <br />tion for each bullding. A separate permit will be issued for each building. <br />Omer •4tf-•d,)14r!" llt Building Address <br />6 <br />Mdress _jSri -3 Lot Block ; <br />City Phone �.5� Subdivision (Plat) <br />' Architect/Engineer •� <br />_ .•:� "'( City Phone Metes L Bound-.. (Unplatted) <br />;,• Ccntractor %, •• i-tu-"-''«, ; Sec. Twp. Rge <br />P: dress 4)-0 - 11 e <br />1 city Ybona1/ Building Use <br />btato License Number P / Describe Work to Be Done ..sue ,c,.o�i'• <br />� <br />( Expiration Date /l�?-/.�'7f ;..�>i ��i_it�.P r .•-r�r+ h �•x et•' <br />SKETCH PLOT PI.,1N BELOW' 4=• $g= <br />Una of Building <br />a ` i . ,,, ❑Hew ❑ Addition ❑ Repair/Remo el <br />•� �• Valuation of Construction $ •/ 3 <br />PLAT PLAN REQUIREMENTS ;+ <br />Indicate lot size, name of streets, <br />-indicate location and width of <br />)� +rye1= ;+:' j'• alleys, locate proposed and all <br />existing buildings, show distances <br />1 J '! to property lines, show distances <br />a v, between buildings. <br />7 ` Lot size x <br />Lot area Sq. Ft. <br />A. = Size of Bldg a;9_ Sq. Ft. <br />'J Number of Stories / <br />Basement <br />`v` • vri_ Signed By '•771 <br />.. For _ <br />Owner Phone <br />DO NOT 101TE BELOW THIS LINE -?OR CITY USE ONLY' <br />Date 'Received I I IT Z i \ Ute• Zono <br />Plan Creek Number Fire Zone <br />Valuation Occupancy Croup <br />Permit Fee -'gyps of Construction <br />Flan Check ree Occupant Load <br />Total Fee Due ?s- OU Sprinklers Required _ <br />Date Issued u4plz <br />�. <br />.r <br />