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<br />05/13/2007 14:32 <br />613-78Q-.OO20 <br /> <br /> <br />4137552404 . REINKE <br />(.;Ity ot LepnyrJIIII~ ,"tlllIlIL r\1-'1''''''''''~'' <br />Building [)epartm..nt <br /> <br />PAGE 01 <br /> <br />Dale Re""lved <br /> <br />owner Phone HumMr <br /> <br />Owner Phone Humber I <br />Owner Phone Numbllr I <br /> <br />owner'. Name \ (L ;T" <br />Owner'e ,Add.... rSl"':}"(,p dJ)~ ~T <br />F.. SImple Tltl"holder N.mel <br /> <br />F.. Slmpl.. TlUeholder Addre.. I <br />LSL~~ <br />I <br /> <br />~/:J... ~1"UJt;1' ---; C.O"hl~ ILL..~ ~L <br />I~I I <br />I PARCEL 1011 <br />(DeTAINED FRO" PRDP~RTY TAX NOnc~J <br />SIGN D MOVE 0 <br /> <br />LOT' I <br /> <br />JOB ADDReSS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />HEIGHT l <br /> <br />BUILDING SIZE <br /> <br />l <br /> <br />r",""" <br /> <br />'1I11f11'" <br /> <br />IlI'T'. <br /> <br />r"' <br /> <br />.-rTT"I.....-,:;r... <br /> <br />IT 1111" .. <br /> <br />.11' <br /> <br />"..... .................. <br /> <br />r'l1fT1 <br /> <br />'If~ <br /> <br />o <br />CJ <br />CJ <br />CJ <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />"(e,J.f.4 <br /> <br />Dc-- 1C <br />\,~~~~~~~~ <br />'7 \~';c ~r~ <br />,v: <br /> <br />BUILDING <br /> <br />VAlUATION OF TOTAl CONSTRUCTION <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VAlUATION OF MECHANICAL INSTAlLATION <br /> <br />Add.... <br /> <br />ELECTRICIAN [ <br />81GNATUftE _ <br /> <br />Addr... I <br /> <br />PLUMBER I <br />~IGNATURE . <br /> <br />Add,... I <br /> <br />:~~~~~L In <br /> <br /> <br />Add...."" I <br /> <br />OTHER [ <br />81GNATURE <br /> <br />Add...". I Weens.. # <br />1111111111111111111111111111111111111111' II 11I11I11111111II1 1111111111111' II "' II 111111111111111111111111111111111111111111111111 II II1111 II 1111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sell; c! Building Plans; (I) set of En"'llY Fonns; R-o.W Perrnlllor new conslrl.lction. <br />Minimum I"" (10) workinll day. aller submittal clalll. Requlrlld OO5l1e. eon5\r1Jd1on Plans. Stonnwaler Plans wi Slit Fence Installed, <br />Sanitary FaclllU. 61 dumpsl8r; 5118 Work P......l1lor aubdlvlslon5lLa'ge proI.as <br />COMMERCIAL AlUlch (3) sets of Bulldlng Plan.; (i) sat of Energy FOl'Ills. R.o-W Perml1 for nllW coostructlon. <br />Minimum .an (10) wcr1dng daY" aftet submittal d8te. Requl,ed onslle. ConsINctlon Plens, SIofm_"" Plans wi Silt Fen"" installed. <br />Sanitary FaciliUes 61 dumpsler. SlIe Work Permit lor aU ~ projects. All commercial requirements mUSI meet compliance <br />SIGN PERMIT AlUla. (2)sel& of Engineered f'lans. <br />....PROPERTY SURVEV requlrlld 10, all NEW c:onslrUction. <br /> <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATUR <br /> <br /> illl? f'{( oJ. ~/I.s- I <br /> I COMPANY <br /> REGISTMeD V/N FEE CURRENT <br /> Uo;llNe 1# <br /> COMPANY <br /> REOISTEREC V/N Fl!! CUFlRliNT L.rL!U <br /> License # <br />- COIIPANY <br /> REGISTEReD L.J:.L!U FEE CUflRliNT l.Y.!lU <br /> J Ucenee # <br />- COMPANY <br /> RliGISTERED L.:!:.LJ:U FI!!! C\lRlU!NT LYl!Ll <br /> <br />..................11. ....... ...l.. .........1...... .... ..... "'" ... .Ir................. ............. ...... ..."... <br />Directions: <br />Fill cuI appllcalioll completely. <br />Owner & Conlractor sign WIck of application, nc:larlzed <br />If over $31100. . NotlCD of comm.nc.....nt I. '.qulred. (AlC uPQ~. ov.' $5000) <br />Ag",,1 (for th.. conlrllelOr) or Power 01 AttomllY (to' the owner) would b. someone with nolarl%ed letter from owner authorlzjng same <br /> <br />OVER THE COUi'lTER PERMITTING (FrOl\\ of Appllca1lOn Only) <br />Ren>Ofs Sewano SlllVIce Upgrade" AlC Fences (PlolISurvey/Footage) <br /> <br />Drlvew.ya-Not over Count... If on public roedways..needa ROW <br />