HomeMy WebLinkAbout2736 WILSON ST; ; 63-5452; PermitAPPLICATION FOR Bu .I IJ J 11 G PERMIT 5452
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(Please Print ) (Lost) (First) (Middle)
Contractor ~ ...... ~~·····························································Mailing
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Address ....... S.~ ........................................... .
Number Street City Phone
To Construct ~ Add O To Alter O To Repair O To Convert [] To Move From ............................................................. .
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Floor Space of Garage (sq, feet) ................................................. detached OConst. Valuation $ ..................................................................................................... .
LEGAL DESCRIPTION
Lot Block Subdivision
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Assigned House Number
LAND AREA ...................................... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE .................................................... {INDICATE
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1
AND L:::~l:.: ... :N PL::.~7 THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
If a check is tendered for Fayment of the above fee and the check is • //} j P Q<f ~ . )
~:;di:~:i; r:~:keJ'.'esented for payment, your Building Permit will be SIG~t~~~i-rE~F~···~···a'~
Front Yard Set Back .................................................................... . Driveway Permit Required Yes { No !H Fee ..................................... .
Side Yard Set Back ..................................................................... . Grading Permit Required Yes ( ) No{~ ................................................... .
Rear Yard Set Back ................................ ····································-Sewer Disposal Plant Capital Cont. Fee ................................................................... .
Distance Between Bldg ............................................................... . Sewer Pumping Station Capital Cont. Fee ................................................................. .
Off Street Parking Spaces ......................................................... . Sewer Main Line Cost ..................................................................................................... .
Sewage Disposal System ............................................................. . Sewer Lateral Connoction Charge ............................................................................... .
Zone -Residential ( Water Stocked Lands Charge ....................................................................................... .
Zone . Commercial Water Main Pipe Line Fee ........................................................................................... .
Variance Water House Service Charge ................. .
Eng. Check By ............................................................................. . Water Meter Charge ..................................................................................................... .
Sub Total ................................................................................... .