HomeMy WebLinkAboutBLD1987-00357 I. LOCATION: progrephicname
NE
S W FROM INTERSECTION OF
S W SIDE OF FEET
ROAD AND 62 C- C it 0e_ On U E ROAD
1
other specific location or landmark: I `
Parcel
DESCRIPTION: c, eri k-n l't- � . - 14
•tC' 1 rc 1e1/-TT ( Lot Block 30 Subd�vf on C . CU
1 15 560 OI 5 Tax Number Y.Sec-loon Section Township Range
II.TYPE AND COST OF BUILDING•
TYPE OF IMPROVEMENT BUILDING TYPE
r�,�f Family PUBLIC WORKS APPROVAL
YU New building
/❑_Addition )2ngle
❑Multi-Family Road Access Permit No.
number of units
❑Alteration
0 Hotel,Motel,Dormitory Utility Permit No.
0Repair,replacement number Ol units 1
p Wrecking 0 Mobile Home Energency Services No.
Moving(relocation) 0 Other-Specify Street Width A:
❑Foundation only
• B:
-- Additional Permits Required:
3 OWNERSHIP
C('"'') 0 Private(individual,corporation,
,,99 nonprofit institution,etc.) ��!!,,
0 Public (Federal,State or local coin.) UBC OCCUPANCY GROUP: g--✓ `
COST (Omit cents) Nonresidential- Describe in detail proposed use of buildings,e.g.,food
• Cost of improvement S processing plant,machine shop,laundry building at hospital,elementaryt-^ To be installed but not included school,secondary school,college,parochial school,parking garage for
.4-^-4 in the above cost department store,rental office building,office building at industrial plant.
te a. Electrical If use of existing building is being changed,enter proposed use.
Cr b. Plumbing Maly) : 113 4I C,to [435 = 3 L Logo
c. Heating,air conditioning '. 113 LI Cl)4 l') Q cl:}i
(" " i)
d. Other(elevator,etc.) (T-4 -P1(• 532 `►'' (c3:i 'T I In _- _I 2_
11' h
• TOTAL COST OF IMPROVEMENTS 5 ))_a L
III.SELECTED CHARACTERISTICS OF BUILDING
DIMENSIONS `.•
PRINCIPAL TYPE OF FRAME TYPE OF SEWAGE DISPOSAL *Number of Stories
0 Masonry (yell bearing) (]Public or Private net),) •Total square feet of floor area,
O Wood Frame Olndividulseptic tank, tc.) all floors,based on exterior
\\ dimensions
O Structural steel
TYPE OF WATER SUPPLY •Total land area,sq.ft
Reinforced •
concrete ;
ublic or private company
J Other-Specify NUMBER OF OFF-STREET •
/ ` ftnme. 0 Individual (well,cistern) PARKING SPACES
• Enclosed .
PRINCIPAL TYPE OF HEATING FUEL TYPE OF FIREPLACE
CI Gas Outdoors
0 Oil RESIDENTIAL BUILDINGS ONLY
Number of bedrooms
Electricity
Coal TYPE OF MECHANICAL
Number of Full 1
❑Other-Specify bathrooms
Partial f
•
IV.IDENTIFICATION _
Name Mailing Address-Number,street,city and State J ZIP code Tel.No.
1- .Ca+herieT e �ney ca a 1 Ca N E_ ( Ci-c1 �f I e rf-c im 9-c�C�`iG, r .` -
Owner ��lr.y5cici i
Ph,til (p� .
I
z 5e1-F ;
tractor State License No. r i
1 1
3
Architect
i
The owner of this building and the undersigned agree to conform to all applicable laws.
c—l•`
g
Si ature of aPPlicant Address date
// s PLANNING AREA FIRE DISTRICT SCHOOL DISTRICT WATER DISTRICT
APPROVED BY Tplj/J- APPROVED 3Y APPROVED BY .
e"‘ 77/
JEF .- -• •u t HEALTH IbEn SHMEL 1 NE CEPT. PLANN 1 NG DEFT. . kAPPROVED B PERMIT FEE ISSUE DATE RECEIPT NUMBER� LSO . 50 .
so
1s ' co 7 0-- 7 a ( ) 'I88
BUILDING OFFICIAL t / O� b
l0 Tier P,.nrriy - Pot T0.+nst•nd 70 i!-{ (,/�\ _
A7 /12,-c. 0/°('e 6 S ;,2 cs•
0(t-' 44"
12-e- cu/A \t\L“i-OrN,
, PPROVED
JUL 1 0 et!--) LNA
Cotifirl tikr&
7 .03•-•€ 7 ez- e2-44a ia_r_e&
7_ -
212,s/a t
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Pcs
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