HomeMy WebLinkAboutBuilding Permit #11-0716 y O❑�- n ❑��O�O � O D Nc�
� �� o 0 0 3 a�y��$ ° z �� mo
o > o � p� 3 �" m � v�"i ��+
� � m m y Ri N �zyz p y p�
�o � � D Z � _���� Z �
ro � —I m
O
C � .� tn (/� " Z Z 0�
�
� o � Z m �
m
� v �
�' �° 0
� �° o � � o❑ooa❑ �f1
� - N v v � �c�Anc
� �e z � ( � 1 ����_� m p v� c
C m � ` yc 3 - m
� r i� O O � —1 � �
� 1 0 � Z 7� �c Z r C'
�° z � m ��� � v
� A � �
= m
� ° � � .-i
�
� y m � ❑❑�0❑
Z � �,��n� � N �
� Z � >��� „� m
� o c� � C����' �
� Z � >mm�� � �
� m �. .�. �
., N �_ Z n �
� m
"� r �
I
�-: —-� CYt'Y U�' YKtUK LAK� KUlLll1Nt; Y�KMl1', llate ltec'd
; � ' ` � \ �"r "�—`
�'�, y� TEMPORARY C�RTI ATE OF ZONiNG COMPLIANCE �� _
' v ', I _S \,; � AND UTILI CONNECTION PERMIT � � �
d ,�Q'
� g s0
` "'''"` �'� PERNIIT NO.
� � �� �
3: Yettar AppFit�t
eax or � si u bottam
' ADDRESS ZONING (ot�ioe use>
J � (/�K.-
' LEGAL DESCRIPTION (office use onty)
LOT BLOCK ADDITION Pro
OWNER
(Name) t (Fhone)
(Address)
(Company�Name) ( � � 'C' C/ � (Phone) l-�� ,��U �.Sr��
(Contad Name) � � ! �S (Phone) KJ " '��
(Aaaress) 7 � 6 e.� e. � ��i
TYPE oF woRK o rrew cons�ucuon One� �romn xe-Roormg plzeSia;ng oI.owa r.ev�a F�n;sn o Firepla�e
pAadmon Onm�von p�rcuuy c oa �� S
CODE: �I.g.C. (]I.B.C. ❑ M� � , e ' �
Type of Const�nction. I II III 1V V A /'�
pccupancy Gmap: • A B E F H I M R U PR JECT COST/VALI7E � ��/ D�v a O�
Dirision; 1 2 3 4 5 (eadeding �)
I hereby cectify that 1 have flunished 'mfocmation � th's appiication which is ro ffie best of my kowvkdge �ce a� mnec� I aiso catify' q�t I am the awncr or aathosized agent for the
ce
above-men - propercy and that , conform to all e�osring and bcal ffiws and will pmceed in acm�damx with submiited plaos. I am aware that ttte building
�os .
OffiC' C3n this pemlit Cnt , I herebY agcae that ihe ' olTlCie1 � a dcs�c maY ��T �P� � P�P�Y � P�ORm �-
x __J� �7 Z�' 2 ,I' 2
5; �� c�n��rs L� xo. nao�
Permit Valuation � �- J Pazk Su�rt Fee # $
Pemut Fee S -�. SAC # �
Plan Check Fee a Water Meter Size 5/8"; 1"; $
State Surcharge S P�� ��T �
Penalty $ SewedWater C�on Fee # $
Plumbing Permit Pee $ Watec Tower Fee # S
Mechanical Permit Fee $ BE►iider's Deposit S
Sewer & Water Pennit Fce S � $
Gas Fireplace Permit Fee $ TOTAi. DiTE $ '�'_ ��
This Appiiotion Beootoc Pe�t WLenAgpm�cd Paid C_ (�-� (� Reoei N
� Date — -1--'' B
, G��'��' �-�'��2
Buildin O[ficia) Date
This is to certify tLat the reyaest in t� above application and accompanymg docu is m accazdame wrth the City ZoninB Ordinanre and may p�oceed ac requegted. Th� document
when si�ed by the Ciry Planner wm�titutes a bemporuy Catificate of Z.oa�ing m�d albws mnstruation to oommence. Hefome occ�+Pan�Y. a Certifirate of Occupancy must be
issued.
Planning Direda D�te Special Caditio�s. if any
�. .._---•--- `---.. � _..___ ..,�., ...:..or. �__ ...r,. .,.. .�.�