HomeMy WebLinkAboutAPPLICATION - 92-00021 - Erickson Pontiac - AdditionVI v
In
Date of Application,
AP&I
CITY
F4R 8L3ILII�Ii1U r�T
OF REXBiTRG, II3AHd
-1%1� ;a
1°
C p
Permit _1(114
CONTRACTOR
Street Address_�141�- fep Street Address
Are
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M
Mailing Address
Mailing Address-'e
City State
city,
. Tei
Telephone
* ephonezffz_y2L.-I��4. 2 -p-
a . Lice NO*
- P,rchitect rEngi-neeri-
LEGALng
ION COPY IF NECESSARY_1
Lot 4
Block Subdivision_
job Address
i a
Projec ion completed by
Residence Comm* Educational
Fence
structure*
1
41 Carport Gar
Patio
New
Remodel Addition
•�y r
L h
Mt - - M-
A
Repair
Renewal
TotalNumber of
door
Stories Height Building
Area
of Unfinished Basement
3.
What 3- structure used for
l name business
applLcable)?
r t how many �
multiplel
Est1mated cos
Use
�.ficati -
Type Constr
% Building Permit Fees Plan check Fees
Plumbing Permit Fees Digging Permit Fees
Water Sewer Hookup fees Other Fees
E*
Signature of Apel Kant
Signature of Building ,7w/ -O
ee
issued by
�
it