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,.r�� � v� v��v��v � H1�.°rrav� �u �y���b/y0 I�F.�I� � •��.I�� N�.�l.�. <br /> • ( <br /> Tob�l Fe�: S `�; ` . � � 13�ro R�ceived: ` �� / <br /> �nt�red Hy: � . '�'% ' Permlt�: . <br /> , C��� ()F tJR�,l�O - �3�Jd�,D�TCx PE�� A�'P�ICA�IO�T <br /> ; - <br /> Att�n�ormntlon mu�t be�trbmi�ted !n �It.�efore,pl�u e�eveew wtll6e started. <br /> �, (�1��pv��t all f►�ormu�ion)� <br /> • :.�.,�__� _�_...�...__d.._.___---�.---.,-d.-_..,. _._._� _ � <br /> T� �ilP�'I:gCAI�I'I'�: (circle on�) 0'�VYYER CONTR�C'C'QR <br /> _. ao� sxx����: _�ya� �a\d�.r�c�.�J� r2� a�: ,� �3�j �;� <br /> �: �r� oF ovmva�: � 1�oh��e.�' � �o�: ��5�a.`� l..boqg <br /> .�, , (work) . . <br /> MAILII'�iG AD�}ItF.SS: C1TY: �I�: <br /> . • . , , <br /> 'VRJ��rai�i J�:�,,,�a.1,�r`uwS�lJ ri�4Fr�Li _tl�s�- a���! 1 ��" <br /> ..C�N'I'ACT�UN: � � 11+I0$II.B/�AG�18: � <br /> ' ' �A�i.II�l'G 1�D��F,S8: 19a� Cam�.gci.0 t�,�.e;�_ CI7'Yi�c�,v;1 ?.�': �Sll 3 . <br /> �S'rAT`� LICEi�: ��OI .� <br /> • �BC�CT/ENGIIVEI�R: PI�OPIE: � <br /> �ri�ILING AD]DRES�4: f.,'�'1'Y: . ZIP: ' . <br /> NAM1�: � �GI�TYSA'1'I4N�► � <br /> . , . , . <br /> 1'Y� O�"6�►(�l6t�i: New Addition Aooessory S�ucWr� ' <br /> 1�iove �R�+anodell�ltetattan Land Alt�raEion - <br /> , __,.o_�__ <br /> IsRO V1�ORK(des�r�be in detai�: (II (,N��1�� � ��`� . <br /> STd�RI�S: SQ,�'E�7'OiF�A►CI3�'L,O�R; <br /> I+�O. OF D�1�00MS: G�AG� �Te�II�LS: A7'T. D�'T: <br /> ��'r�� co�s�tucrr�v v�►i:uArton��e�r�a�n��a�a�: � ly � °�/ <br /> I�a��by apgty for a rtsuilding permit arad I ac6�n,awledge tbat tt�e infonriadon aboee i�compl�to an� <br /> acc�ratc; that d�e work will be ia�onfarmanse w�th the ordinances and podas of th�Ciq► �d vvith <br /> , ' tho Stat�Building Cadd; that I underatarul t'hjs ts not �permit�nd wot�C is not to stairt�++itbout a <br /> .' peaa�ait: and that tt� wotk will b� �n accotdanco wfth the.�pprod�d plan. • , <br /> A�PLI��NT'S SI�r1A'A'�1�: II�A►T�s �-��V'd� <br /> .�o.,._.� <br /> 1V0�! ev�r�s r�gailr�aep�nate permit approvad b�► �al�ce DepaP'�ent mtd . <br /> [�ity Co�tclt 60 a(ays prlep ao tha evant. 1Yon p�rmt�ted ev��tt� �vJ�a��t be all�wed. <br /> £/Z ' d�o�LZL6 ' �N�;T,,. ��� ,� , , ,,,A„ ,,. :S3NOf �3013, ,WdZ l � � .,ZOOZ ' L ' ��N <br />