Laserfiche WebLink
v •s,uu♦ <br />AC[LLl1\11Vp •�'•• <br />�•J <br />• ,. 2 <br />• <br />Applicant To Complete This :orm �7f <br />i+ a�y�2� <br />' <br />If more than one building is to be contructed, submit a separate permit a _li <br />lion for each building. A separate permit will be issued for each building. <br />i J <br />• Owner �;�i:t ' ; <br />Building Address " �•C . <br />,y�oi.,U <br />I <br />)ddress <br />Lot Block 44 <br />^• _7 rnone <br />Subdivision (Plat) <br />)rehiteet/Engineer <br />i ✓' �� <br />City Phone <br />Metes i Bounds (Unplatted) <br />Contractor <br />Sec. fwp• Rge <br />'i <br />Address <br />t <br />City Phone <br />Buildino Use '.. <br />• � <br />State. License N=ber <br />Describe Work to Be Done �., _c /. •;..4_ <br />I <br />Expiration Data <br />n r_-� _ ta <br />�,� <br />SKETCH PLOT PLAN BELOW <br />_• <br />Dse of Building Ca <br />L* <br />New ❑Addition Repair/Remo el <br />i <br />.• <br />i <br />A <br />Valuation of Construction $/Ob' UO <br />PLOT PLAN REQUIMIENTS ; - <br />2gdicate lot size, name of streets, <br />�. <br />-indicate location and width of - <br />;': i <br />alleys, locate proposed and all <br />17 <br />existing buildings, show distances <br />s <br />to property lines, show distances <br />between buildings. <br />Lot size x <br />.. <br />Lot area Sq. Ft. <br />Size of B g. Sq. Ft. <br />Number of Stories <br />Basement <br />/ <br />Signed By <br />1, <br />For <br />Owner Phone <br />• <br />DO NOT EMIT- BELOW THIS <br />LINE -FOR CITY USE ONLY <br />Date `received <br />Ut a Zone <br />i <br />Plan Check :lumber Fire Zone <br />Valuation Occupancy Group <br />Petnit Fee type of Construction <br />Plan Check Fee Occupant Load <br />Total Fee Due Sprinklers Required <br />Date Issued <br />r <br />