29-250 (2) ZONING •
FRONT DISTRICT
USE
SIDE YARD SIDE YARD
REAR YARD
NOTES
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — .%'umber, sfrcc f, ( rl�, crud Staff ZIP code TAI. No
Owner or 1 J�-i d (( GCf!Er t/C L' /Y/1� d�i®iF 6' q f Cj/U L(:— �O 7
Lessee
Builder's
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 app ' ant Address Application date
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING
PLUMBING v
MECHANICAL
ELECTRICAL
OTHER
Vi. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obta ned Number By Permit or Approval Check Obtained 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 OTHER
VII. VALIDATION
Building
Permit number 199
Building
Permit issued June 197_
Building
Permit Fee $ 10.00
Certificate of Occupancy S
Appr e y:
Drain Tile
Plan Review Fee _
TI LE
l rzty of Nart4alnptan
� { �IIM48F1Ch lis t'tt8
T'A Office of the ,Inspertor of `Ouilbings
APPLICATION FOR
�3 Plot���`� ZONING PERMIT AND
Page BUILDING PERMIT
z
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. O
ZONING
I• AT (LOCATION) DISTRICT
� � L G% LGtL'/C d['/�"
LOCATION —(NO.) (STREET)
OF BETWEEN AND
(CR055 STREET)
BUILDING (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D m
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
I
1 ❑ New building Reside ial Nonresidential
2 ❑ Addition(If residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
i 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 F—] Wrecking (IJ multifamily residential,
of units -------- — —� 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 Carport
24❑ Office, bank, professional
❑
6 ❑ Moving (relocation) . u � 25 ❑ Public utility
17 ❑ Other — SpeciJy
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP iT 416eciC e.41.4iAi.rjV;�O' 27 ❑ Stores, mercantile
8 Private (individual, corporation, / 28 ❑ Tanks, towers
nonprofit institution, etc.) 1_/t%Si✓.rriJy 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................ _ 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 �2S,
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
0
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS m
48. Number of stories...............
30❑ Masonry(wall bearing) 40 El Public or private company
49. Total square feet of floor area,
41 ❑ Private (septic tank, etc.)
31 Wood frame p all floors, based on exterior
32❑ Structural steel dimensions .....................
33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY
34 ❑ Other — SpeciJy
42 El Public or privote 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 0
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 54. Number of be an elevator? Full..........
46 ❑ Yes 47 bathrooms No Partial........
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
A
SIGNATURE OF AGENT
ADDRESS *,
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE t9
— DEPT. FILE COPY
z
BUILDING da
• ERMIT VALIDATION
DATE j ri@ 2' 19 22 PERMIT NO.
APPLICANT Ri nhsard S Marton ADDRESS
( S ET (CONTR'S LICENSE)
NUMBER OF t
PERMIT TO Build CAfAaYtf Mack nhgy STORY DWELLING UNITS i
(TYPE OF IMPROVEMENT) N0. PROP D USE)
ZONING rTrt,„
AT (LOCATION) DISTRICT
(N .) (
BETWEEN AND
(CROSS STREET)
(CROSS STREET)
LOT
m SUBDIVISION LOT BLOCK SIZE
a
0 BUILDING IS TO BE - FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
10
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
0
LL
AREA OR PER MIT
VOLUME ESTIMATED COST $ 125-00 FEE $ io A0
(CUBIC/SQUARE FEET)
OWNER Richard C Marion
ADDRESS 126 Ovar3aak •e
(Affidavit on reverse side of application to be completed by authorized agent of owner)