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� CITY OF CRC:IO - BUILDI�IG FE��ST APPI,IC�TION
<br /> Date Received:
<br /> :.ta1 Fe=: $
<br /> Da�e ADD?"O�i 2C:
<br /> i
<br /> _t@r2� nV: �' - %. . �
<br /> Pe�it; y'��> / .:�_
<br /> �,'.. INFORI�IATION MIIST BE SIIBMITTED IN FDLL BEFORE PI,�'�N RE�7IEW WII.� BE STARTED
<br /> (See Check-off List Enclasa�
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<br /> �E APPLICANT IS� (circle one ) O�+T;�ER or�CONTP.ACmOR
<br /> _�
<br /> � —;
<br /> JB SITE ADDRSSS: l /�j �• ���'(-�-'� ������ � ZIP:
<br /> (work)
<br /> --� � r, � �j, ../;i� - /�. � % �
<br /> (��,�w%,� r ,��-�_ ,, �.���"' i'l� (;�,.� PHONE: (home f � � _`
<br /> �ME OF OWNER: -
<br /> )�' "� �' �'.� , , \ ��,�� CITY: mj�X�-; l�� ZIP:
<br /> 'AII,ING ADDRESS: 1 ��l� �� l.��J�I� ��`. -
<br /> " 17� �; ,•-�:- ��'7 � � � PHONE:��� ' - ! -�j '� i
<br /> �NTRAC�'CR: 1 �.-�u bv11.v�.,�•.VL 1�e�1
<br /> t �-"��'7 � n �� .�� � CIfiY. I �..;,�:°�ll�j!�1Jf1'i ZIP: 'c -�f�� i
<br /> ?�.II,ZNG ADDRESS:t � � o� �� -
<br /> ;`�,f l('� � j � �
<br /> T�.TE LICT�`ISE: - � . _. �
<br /> PHONE:
<br /> :CHSTECT/ENGSNEER:
<br /> �'�IZING ADDR.ESS=
<br /> CITY: ZIP:
<br /> �MF_ REGISTRATION -
<br /> ''PE OF T70RR: �7ew Addition Accessory Structure
<br /> riove
<br /> Demo R�*nodel/Alteration Renovate Lar.d Alteration
<br /> 'be in detail) a+ :itf'Jt�t��� C;�i��,9,',� �i'li,�-�'? !�T,� ,i((�y�^ Y� � � :.�`��"
<br /> �OPOSED WORR (descrz . , �
<br /> �` _� ! ��� ; � ��� 7�� � ���
<br /> (' � �� ,��' (�i('���1 " ���D I�`'• �.,11�iJ.�� C�C", � V;.��`�-f :_f' � 1'r• .. ��� ��' � . �.l� �% -
<br /> (f'A..��. ;11� t �) ,� x � � • ,� - _
<br /> . ,.�j ,, i,��/.%r�r�-S �/�, d.,� A.�(,A.�I�S-I' �:(`. , l_� _, - .� ,
<br /> ; � ,�: v ',1"�V1�a �° /yJ���
<br /> /���(.v ''ij j�_,�/%' , - � _ , _. -
<br /> °'ORSES s SQ. FEET OF EACH FZ,OOR:
<br /> )_ pg BEDROOMS: Gt'�RAGE STAI.LS: ATT. DE'�'.
<br /> ;�",!--
<br /> .3TIMATED CONSTRIICTION VALUATION (ezciuding Iand) : 5 � �'��'-'
<br /> hereby apply for a building permit and I ac?cncw�e�ge that the in�or=nzt'on
<br /> �ove is complete and accurate; that the work wil _ be in conforinance with the
<br /> -dinances and codes of the City and with the S�.ate Buil.ding Code; that
<br /> 7derstand this is not a permit and work is not y-c start without a per:nit; and
<br /> lat the work will be in accordance with the Papo�ved plan.
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<br /> .. � , � �� l, � ��
<br /> ; �., � ' i /�' �� DATE: �
<br /> ?PI,ICANT'S SIGT�IATDRE: '; �`
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