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<br /> `"'�"`` CZ'1? OF OROHO - $IIILDTNG PSRKIT APPLIGTIQl1
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<br /> �.;'�POt!!I Fee s S �c 7 Y� 3 S Date Received sQ� Li- �Q
<br /> ��'� ' � Date Approved s
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<br /> '�tered By: Permit#: �7 � 3
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<br /> �]'.T, Il#pORMAT20P l�IIIST BB SIIBMITTED YA P[TLL BEFORE PLAN RBVZffi4 iiII.L HB $TPiBTBD
<br /> '� (See Check-aff List Enclosed)
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<br /> ^�HE �ppI,ZCAHT ISs (circle one) OWNER or CONT'�ACTOR
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<br /> ",srrs an�xsss: �°1(lu `���ti-��► t���--�.,u�- 1�1��z�-• z�:
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<br /> �;���- (work) 3�-59$1
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<br /> � � �: U A � � ���\U :�$�F.:�t101AG� —
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<br /> I PHONE- `
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<br /> I ��l�,��Tu1CTOR: �E ".
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<br /> " LI1JG ADDRESSs. CITY: ZIP: "�
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<br /> g;pF �: New X Addition Accessory Strncture Move
<br /> '�"'Deata - . Rem�el/Altezation Renovate Land Teration •
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<br /> �` �O�S,-(describe in detail): t-XC.�v•�— �•� } ��z��ac.S
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<br /> $13,�e F.�r�. . .._
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<br /> k��;.�,�. e.�-j Cixg,` �r�z�s: Cn+-�c.rr�-t� -.
<br /> ;*,.��a •,� � :;3Q.. PS�B'P OF EACH PI,OOR: � y�
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<br /> �s:- GAR�GS SSl�LLS: AT`i'. DET. . - T�
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<br /> F�pH V�IIATION (ezclndinq Iand�z S �1`�s 100 •oo _
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<br /> :S��a„PPly,��or'a buildinq permit and I acknowledqe that the information �"
<br /> �.,s�-.�omplete..and accurate; that the work will be ia conformance with the �°
<br /> �ces��tnd:�dodes of the Citp and with the State Buildinq Code; that I .
<br /> � �this�'ia.nat a permit aad .work is not ta start without a permit; and Y
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<br /> ` ` tk':will::be:.ia accordance with the approved plaa. : �.,�
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