29-485 (6) ZONING
DISTRICT
USE
FRONT YARD
SIDE YARD SIDE . ,
REAR YARD
NOTES
IX. SITE OR PLOT PLAN For Applicant
��� Till '�' w • aaw■wwuwaawwwawHr
: �r■ ' rSi� :■• Ski•aSrit�•■•�1'•rriSi :ii::iiiii::iiiiuiii
�l��• :■ • NaHi■ • iHNrM•S• N::riaHi■N aria
�; rt•S a S :t i • ���s!� :::■i•::■�•Ir5:`ir:•:n*■a�:r��tiuo:ll::N•�•p/'::�.oi:t�:'•::r a■:i•:��.rills:■±:s r�:•�r'■■tt.s■H ttt',■���S�ry.r■■N�♦'t//i/r,�q��..i'!�ii.aar `S*+R�i • r'�■n pM�•�t•ri�•■•r■••:t Is:Si•:t 5:N?:i rSi•N•■*S:.R\:S•H S.M rs rrt::l
r nu/N/i S[N:a i uHN i•i■qr i/i•u:.N:q Nri ot/iif ua•i•■iNHNiHai NNNt:aHt:■N•Hi_NM N:■
r NNa• r■■s r■•Ho:N a r iN/•o\N■uii■HHN■1rr■H■r•H
i•r■/i■
a ' i � :
mall:r S i S t ■arr a �•r _ : ■NRi / •:: � ■ ::
•t \ is ■ ■ rq: N
■ • n ■H Nr•0 N■rH■■•:•: i i• • H ■ u SaH:i:::i' .3 : s' : ::: :
46 NrlM . :
NirNU■onurou::►.INSr •: •1
'Nr
aiS •/ :a■ a ••nN• unr00:30sar•
1 na a■.
• r �•R.r!S '•:s ;in:•�'1�ri an
■ s i H • N •• qff ■H rgtNar■■frNffriH H■Na
� �i • • s:�■ s:•i•i=ISia•t�i�:iN•l!3NOrgH■wH\gnmqun
:� • ■ R ' a'ii:iiT iii =s::=ii'f:�i i::i:i�::: : r : a r: n\ �arnaai;i :_■::::i::::i:::::::::::::::::::::::::
1aN. : S<•iHNram giuuiH NHa1rN■uuu
• • r rsa rZ •F, •■r .I qar \ • HN i an MfHnq•nnH
• ai ■ •Sa :i. :a 'ii a iaSN■ni:•■n••q/HH•
•••s��aia x�i[# • i � : :•aa rq■rHHrgnn=oggn
.a.l N•• *N• •���� ' ,, • i■ rN ',� �',Q�• w ,�.:q■ iggir N\HH• H■Hni
q■i :.ssil�Nri iS ■ aiNrMiui\?ss::E �s irr triaq�Cii � N�G'rG■H`iirut�arHru•:ururr■■H_■ru■a
• !:����r ar�tM •1}SHr Naiplltr • rO n f • ...Ni •tR•R ��..RRii•iaar■I•■i�irH • •H■ N/i\ ■rN\■
" �. R•• •a .• ■ t I.�::�i a a : a�■ � �:i ���S:-f::iS :• tSiiii:::SS :S:%::
R • ■ ■n ■t_r • •�S..f■o HgrNnaHH■N•
l' ■ ! r i riiStiia:r✓ S q ra•S t■ai•• •:OR::uS:e■•�•I:iri: :r: ::ii:
j, /�s �► ,'I:dN/. "•Ci el••ii:! : S r t• NaigiH■ • N NSIMU r•
�`i .Ini:r s\SNi • a : �iia:ir� :iinN•HH■i ■::■HO/Hrra•
i' .:�rttNlqiq ,: : .■■•i �iiR aN .� ••p. : . . r.•••rr. ■Nq. .■ . N ............ ..
• Mt • rI�FY'N ,d�• =■a■=■■■ ir:'/aFNSS■fa■i .. rN : �qi:•.urgnoSrliS:S■N■rHHlNauq■:N
I •■ /rI•Ra� arr,[f� H rr so .`tin vaNrrarsrni n�t••ar�I �r• ■�q�rn. N �. H■ �ior��••11•■■1liiiiNyrsNir■v •Hris\
I : •R■ �I�i:sn iaN:SS 1111Si*gil•11•ISrin:S:iiR s Y ." SrrS:f.■i•Ii1:�:ii rn•nR game," ■qq::
i ■ j� s� • at .a.ir■ •: Ri ai Ri:::: i • a: ■i�..q.S.11.■S.SairlH• �........ .a
:Illli: •r i t;::: ■::t i r1 irk;"; • q N ■ tt qHr n ■ ■ •M•■•H ga■l: ai
■■ a r • N • grirN • ngnH•H•■■ • s rq=a n:=�a =m■�i■S=i/•ri:i►• r■ni:
a��rS:•iSSSsS : :S:SS■:ii■Irla rr�i ',r, ■ • S :HS •n •■ t■ ■aaH••
: iiisiii�i:�•Qii=i':i:oa`u::u:nri� ii� �, � ■� •1Halin=q=o • gnrgH=
■ • H Hauua r■ N • Hq r n •■•a\aru:uuuuuu
s a :l� s::' • -l�N u•r�=I••r=:�ls :S�i ■unrri'a•t t•r r■ ■qi n■ rurrHNrgr
raYaS :SN■S:S•igoHHNr
■ �s p q =:ii::• t::::311x, a� _" ' q..aaiirHN•t■......
• • H :.. :i:a H ■•H • ■ : •::nt •■■rHH Hr/
s = SMI ■ • s•�IS.�y.: : N H■ �� ■Sq • it man**:i• :::::u�ai'•
,' :. •a�N ittr ..+. . :•.�y■iyirriai ;,'�j'�j����'.'�'''' • Sr • :•SStas Sa_.aaairttt•:SS:S11 a
1 r■ • : R N ■• : a�: IMN�ia :NN S/III'ii i1R•S■•i q =i: i:a::�S ..:Sa:090, iS
i I : = N : Sar a = "■■■■■■!!!!!! 'I II • q • ■• i ■ • : =amll laaallo:
• ■
� IR • oa
aRi ■i aH S Nta■H\�
1•�=''j� •.S:a■' N: a q • Nagsr/gHraiir
wassomens
�� ■ • R • H■ Ni�•i r�i : ,�. N•i i rnrHH
■ urHNnr ■I n
Riva aai
nowmal
• • i • ••l� HHHHgtNI
'ii �n�••■ �!�__tq 7'�+j+s�i'•�i :Uiii:ir•iii
■
i ii:::::uaa
• nr Hri Hral
1
si r 'SS i n' ffisi
■ iui � • • ■\ri:qui:•
' : � i ■iraii��rsi•i�:i :S�
r ii •i r �Ii�rMUl::��iS.N��
■I
son 01
r • 'it, i ��rHi I
NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, strcct, cit%, and State ZIP code Tel. No.
Owner or
Lessee ✓
Builder's
L.
License No.
Contractor
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
t
'
D0 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans B Date Plans B Notes
9 Fee Started y Approved y
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER $
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date D
Permit or Approval Check obtained Number By Permit or Approval Check Obtta tned Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER I I OTHER
VII. VALIDATION
Building
Permit number y
Building
Permit issued 19
Building
Permit Fee
Certificate of Occupancy S
Approved by:
Drain Tile
Plan Review Fee $_
T L E
Crx� a� o�# Dui ton
} 4
� � �[ztssMdTnsetfs
t (O#£ire of the �nsptrtor of 36uilbings
APPLICATION FOR
Page Plot ZONING PERMIT AND
BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. p
- - ZONING ,�11
I. AT (LOCATION) ,j ,''` f `Ll , _ �3- DISTRIC4
LOCATION (N0.) (STREET) L
OF BETWEEN - �a ?.,r.a, Z. AND
BUILDING (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — A11 applicants complete Parts A — D
M
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use m
1 ❑ New building Residential Nonresidential
2 El Addition(1 residential, enter number
/ 12 One family 18 ❑ Amusement, recreational
of Hein housing units added, if any,
in Part D, 13) 13 ❑ Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — --)� 20 ❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4 ❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (1/multifamily residential, of units ——————— — -i 22 ❑ Service station, repair garage („
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional w
Part D, 13) ❑
16 Carport 24 ❑ Office, bank, professional
6 ❑ Moving (relocation) 2 ❑
17 ❑ Other — Specify 5 Public utility
7 ❑ Foundation only
26 ❑ School, library, other educational
Stores, mercantile
B. OWNERSHIP Y`
27 ❑
8 ❑ Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29 ❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings,e.g., food
processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement,,,,,,,,,,,,•.,, ?;_ l�J school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical.....................
b. Plumbing .....................
c. Heating, air conditioning.........
d. Other (elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT $ OD
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV. y
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS O
m
30❑ Masonry (wall bearing) 40 ❑ Public or private company 48• Number of stories..............
31 ❑ Wood frame 41 ❑ Private (septic tank, etc.) 49• Total square feet of floor area,
all floors, based on exterior
32❑ Structural steel dimensions .....................
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34❑ Other — Specify 42 F7 Public or private company 50. Total land area, sq. ft. ...........
43 ❑ Private(well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
.D
51. Enclosed ...................... r
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
35❑ Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 ❑ No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47❑ No bathrooms
Partial.......
sLL
�j��� �� � � ��i
t
z
$ �
t� �.
K f F
e�3� t�^`� �'�`�`
^� ,;a
� we
a�wxG`_
r �
N,} s � k Px� - _ � .q r.
t s��,'" �4 g d s �' �..
'C"R F fir{, S.-_„ ,yyF � .;J� ���
+gym
3 k .z'^Y. # B .y" .- ` � '4th "yK
0.
tT f a.�� � '> h,-
�� � ice. � r �, a .r'*- r.�x� :s ' :� �, �' t x .,
t. y'L y.. *�. P'
�``
,!
a F
1�! 7777 g
* }
iff
s
8 F wit
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to maw rthi� ppica#istr �Mfis
authorized agent.
SIGNATURE
ADDRESS µ „. ,. . .. , . ' 4 3
(NUMBER) (STREET) (CITY)
APPROVED'-W' '" 'TITLE
DATE 19
DEPT. FILE COPY
Z
CITY OF NORTH ANMN BUILDING a
PERMIT VALIDATION
NORTIAIG� Ox, MM. 01060 29 - 359
DATE Aep+.emba-r 23. i92_ PERMIT NO.
APPLICANT Do=t_hv __ ADDRESS
(NO. (STREET) (CONTR'S LICENSE)
PERMIT TO (,) STORY
WNUMBER OF
DWELLING UNITS
WY I441 OF IM ROYEME T) NO. PROPOSED USE
ZONING
AT (LOCATION) DISTRICT
(N .) (STREET)
rn BETWEEN A.338ti n ci=p sT AND ,jatirf ci-cl
CROSS STREET)
a (CROSS STREET) (
LOT
n SUBDIVISION LOT BLOCK SIZE
m
a
0 BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
m
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
- (TYPE)
D:
O
L REMARKS:
AREA PERMIT
.
VOLUME ESTIMATED COST $ + FEE t�.00
(CUBIC/SQUARE FEET)
r
OWNER Ralph & '[o=th�vsy,. Z 1,,,. BUIL
ADDRESS `>t'3 1 `ebMo D14V®, �t'lerefte BY
(Affidavit on reverse side of application to be completed by authorized agent of owner)