Laserfiche WebLink
_ <br />BUILDING PERMIT APPLICATION J p y <br />Applicant To Complete // a <br />This corm <br />a a�. 7 <br />If more than one building is to <br />be contructed, subm:.t a separate permit applica- <br />tion for each building. A separate permit will be issued for each building. % <br />Owner Ndi�ih ��h,/S�rrNf1 <br />Building Address 7�/9 11 ; <br />Address QIS 1101A PI SE <br />Lot a Block <br />City /yc•r Ig Phone 03Subdivision (Plat) 94//rnr/ rtlj <br />Architect/Enc Lneer Sc. 14 <br />4 / /(r /?tj e J$ <br />City Phone <br />Metes 6 Bounds (Unplatted) <br />Contractor �',•„ f- <br />Sec. Twp. Rge <br />Address <br />City Phone <br />Building Use (sr; <br />,.; <br />State License Number 1-1-ND SH•/a,338JFi <br />Describe Work to Be Done /l/Na.' <br />c tl1IN <br />1 <br />Expiration Date 77 <br />-�' <br />SKETCH PLOT PLAN BELOW' <br />Use of Building �PS��i`si(• �j. <br />j <br />EIPew ❑ Addition ❑ Repair/Remo:el <br />1i <br />Valuation of Construction $ yE, ScY/ `-;1 <br />a ' <br />a. <br />-•• • <br />unH �( (Y <br />PLOT PLAN REQUIREMENTS <br />• <br />Indicate lot size, name of street, <br />3lrm', <br />indicate location and width of <br />Splri rh�:� 3 <br />alleys, locate proposed and all ' <br />" <br />existing buildings, show distances <br />to <br />n <br />property lines, show distances <br />(� e d <br />between buildings. <br />M V <br />. <br />K <br />Lot size 70 x /30 /a ;ArLX <br />kky • • <br />i;, <br />Lot area/O(1 Sq. Ft. <br />i <br />Size of B g. 5q. Ft. <br />'j <br />t\ <br />Number of Stor es <br />.' <br />1 <br />, <br />le <br />_ <br />BasementNC[ <br />Signed By ALA <br />• <br />For Sf <br />Owner Phone - <br />DO NOT WRITE BELOW <br />' <br />THIS LINE -FOR CITY USE OIILY <br />Date Received <br />ULe Zone <br />Plan Check Number <br />Fire Zone <br />Valuation <br />Occupancy Group <br />Permit Fee <br />Type of Construction <br />Plan Check Fee <br />Occupant Load <br />Total Fee Due <br />Sprinklers Required <br />Date Issued <br />