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" . y <br /> t��� <br /> APPLIGTIAV fapR BUILDING (ALT6RATIW b .1DDI7`Id�f� PBIINTT °` <br /> VILLA� OF Of�10 <br /> .�tM�S C. �IL��kSS � <br /> tA�sr's Name �iJrl£',o� t�T� A�(s � Builder's rYwe_��ON� �N�.�1C�ic�1 � <br /> yc� as TN � �•'� <br /> . <br /> �ddress G.`(`•.�(�rc.¢ �T ��i�, A�ddress L��^ - M�l SS�G► l� <br /> �oee � �7 3 �'?3�t , pho�ne � _�'!3— �9 3 <br /> rro. Z street �t� 5�1� 'bTl-� • <br /> Lot = Block 3 �lddition Mq�v�LL� _r„� <br /> Loc+�tion of Lot: Carner Lot � lnside Lot LkeshoY+e Lot <br /> �- ___ <br /> Lot Mse�nsio�ns: F'ra�tt $7•S Rear Side �C_ Atw <br /> � <br /> structure Setb�cks: Front � Rear � Side 30_`_,L�loeslare <br /> lvetlands: Yes No _� Area if an�► <br /> Special H�ovisions: Variance: Yes No 1ype: , , <br /> Dste Apg�raved . :{�, <br /> ,� � <br /> #,F, <br /> Lot Changes: Spiit Co■�b. _ Dir. �Date �.�� <br /> Applicant attach to this fonn two Certificata of of Iot.a�d proposed bu�tldi� <br /> lo�atioz► drawn o� these surwys. A�at t�o sets of buiidi� .plans. <br /> Plan check and site inspection before permit is issued. Residar�tial - 2 days, Co�- <br /> mercial and In�ustrial - 2 Neeks. Plan Check Fee �ust be sub�itted xith appllCatian. <br /> Plan Q�eck Fee � Residential - 501 Buildin� Perwit Fee � ,. <br /> Ca�wercial $ Industrial - 65� BuildinR Pet�it Fee <br /> D�escription of Huildir►g: <br /> Ta be used as: ANr��C '(o �CI�tL'f C�jT��AUU Tt1�? ! �-Z��1�3/ <br /> �.� <br /> � • <br /> Dfnenaicns: Front �,.� � Ik�th SZ.o ,�Hei�t ?v� <br /> Sq. Ft. �FAB�r�, (�. Ft. <br /> Fro�t Depth Hei�t <br /> ...r , <br /> Sq. Ft. Cu. Ft. <br /> Type o� Construction �(f� V �N} B�Li�ated Cost �5� � <br /> — <br /> P.stimated C.ompletion Datc: Pclk'�U�'( 3� ►q.7b ;�: <br /> r� <br /> � <br /> , <br /> � <br /> �,; <br /> ^►,� undersigned hereby makes application for a bullding per�nit for the �axk as hernin :.. <br /> s�*-cified. agreeing to do all work in strict accordancr with the ordinances of the �• `�� <br /> L'z?lage of Urono and nalinRs of the State Departeent of Building and l�reby declares •^' <br /> th.�:� all facts and representations stated in this application are ttue and correct. ;,A`•� <br /> ��?n f n; r���� � � �r� SiRnAtui'��•.. /' �' � �'_ <br /> _��,;r. ' �:, �_.:.L L_ � <br /> � --•� r f�ec PI�n Chack Fec <br /> ______r ......._ -- _ ____. , l _ ,: <br /> .-- �:,,r:.p,;,rr^ `i11G t?ir�c�e <br />