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Gi�Gy o1'Gepnyrnu�s rC.11111L H(JNn�,n��v�� • . <br /> 8�3-780-002D Building Department P�� �� f�3'��y-`r`3�y <br /> r _ �� ��3 _ I�I_ v <br /> Date Received -7-j� Phone Coniact for P�mii'i g�� I-rt- /� � 7 <br /> ( . - <br />-rHti-rri-t-�-rl-i-�'�"r' � ��� Owner Phone Number <br /> Owner's Name ��n . ' <br /> 3 y a� ���� �,�- . Owner Phone Number <br /> Owner's Address . <br /> Owner Pl�one Nurriber <br /> ree Simple TiEloholder Name , . ' <br /> Fee Simple Titleholder Addr�ss � . � LOT�� S� <br /> 3 ya� � /�?c�/��i(�.- �- .. 2-e- /^ . <br /> JDl3 ADDRCSS ' • i L _a�_�ao-��- �aS3o <br /> 7i(� E��C �OL�Y� . PARCGL!D# ���ow <br /> SUDDIVISION • — (OCiTAINE�PROMPROPERTYTAXNOTIC[) DEMOLISH <br /> ' ADD/ALT �] S��N 0 MOVE 0 <br /> • NCW CONSTR � ���A�� <br /> WORK PROPOSCD � INSTALL • • <br /> S�R ' �• COMM [� OTHER aT�_�ER <br /> pROPOSED USE' � � pLOCIC 0 FRAME � .� STGGL � <br /> 'IYPG 01=CONSTftUCTlO[V � . - , ' <br /> `a--/1(,L L " � . . , <br /> DCSCRIPTION OF WORK . • <br /> 2oZ- SQ�OOTAGC ��� hICIGf-1T <br /> BUILDING SIZL- �a-x'`� . . • <br /> � 13UILDING � /D �iV1 VALUATION Of-TOTAL CONSTRUCTION <br /> (�(l � W.R.E.C. <br /> AMP SCRVICC 0 PROGRESS CNCRGY �_�. <br /> � ELECTRICAL � . • . <br /> � pLUMBING �� ��J ( ' I - <br /> � VALUATION 01=MECI-IANICAL INSTALLATION • . <br /> MCCI-IANICAL $ <br /> GAS �] ROOFING �] SPECIALTY � OThIGR ' NO ' <br /> 0 1=LOOD ZONC AREA DYCS J� <br /> 1=1NISi-IED FLOOR CLCVATIONS . • � <br /> `� COMPANY �� � fEC CUftRCNT Y/N <br /> 13UILDCR j���v R��ISTCRED Y! N , <br /> SIGNATURC . . License� <br /> Address 3 ya� rn �- ��- �'�: � ' <br /> ' • � � COMPANY �w�'`r Y/N <br /> CLGCTRICIAN REGISTERE� Y/ N F[E CURftCN7 <br /> SICNATURL License# <br /> Address `s�� • <br /> ' • � � �O • COMPANY ��� r Y!N <br /> PI.UMBER • RCGISTEftED Y/ N fGE CURRENT . � <br /> SIGNATURE • License# I <br /> Addross S�`"�" . <br /> • • COMPANY Y!N • <br /> MECI-IANICAL RE�ISTCRe� Y/ N 'r-ee cur�ReNr � <br /> 51GNATURE <br /> .License# <br /> Address � • '. <br /> � • COMPANY Y/ N Y/N <br /> OTFIER • RCGISTERED f-CC CURRENT <br /> SIGNA'PURC . • � <br /> License#t __.________ <br /> Address , _ _ --- ' � <br /> Plot'Plans;(2)sets of Buildinc�P�ans;(1)sel of Gnergy t=orms;R-�-W Permltfor new construction, <br /> RC5ID�NTIAL Attach(2) Stormwater I'lans w/Siit Fence installed, <br /> Minimum ten(10)woricing days after submittal date. Required onsite,ConsLruction Plans; <br /> Sanitary 1=acilities&1 dumps(er;Site Worlc Permit for subdivision�sll 1�9set of 6nergy Forms.R-O-W Permlt for new construction. <br /> COMMERCIAL• Attacli(3)complete sets of Building Plans plUs a Life Safety Pag ( ) <br /> Minimum Len(1�)woricing days after submittae m�t fo all�new p�jects.All commerc a�requS�men stmuslL meel!coimpliance,nstalle , <br /> Sanitary 1=acilities&1 dumpster.Site Worl<P <br /> ' S1GN PERM�T Attach(2)sets o1'Engineered Plans.� • ' <br /> ****PROPERTY SURVEY required for all NCW construction. <br /> -ri-r�-F+-i-i-ri-i-rFr�-��-►-i-�a+�-�-�-�a-�-�-�+i-�a-�-►a+i-rri-ia-�a-�-�-►-►-ri-�-�a-ri-waa-i-i-F�-�-ia-w-i-�-►-ta-►-ia-rH-�-Ma-�a-i-rt-r►-rrta-i.ta-�a-�-ri-rri-�-►-H-ri-w-�-i-rri-i-r�+i-�-�-i-ri-i-ia-�-Fi-ia-rr• <br /> .� <br /> Direcfions: . • , <br /> Fill out application completely. . <br /> Owner&Conlractor sic�n bacic of application,notarized rades over:G5000) . <br /> If over$2500,a Notice af Cammencement is required. (A!C upg S�me <br /> ** Agent(for the co,ntractor)or Power of P;ttorney(�For ihe own�r)would be someone with notarized letter from owner authorizing <br /> OVCRTHCCOUNTGRPGRMITTING (Fronto�Application�C) �ences(PIoUSurveylf=ootage) � <br /> Reroofs Sewers Sorvice.Upgrad�s • <br /> Driveways-NoC over Counter iT on public roadways.:needs ROW <br />