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� - - , CITY OP C?:Ftt7NQ ^- ��1ILbtNG FI�'12MI� 21PPI��CJ�TION <br /> To�a1. �'ee: $ ,,,,_, i�a�� R�c�i�r�d:. -- <br /> Uai�e Ap�zoved:_ -- <br /> &n t e r�d �y: ---__�__�_�-�--�-- P�r.m i.��:�����U 1 <br /> AI,L YNFURMA.xI0Ir3 �'4L�aT 8� SCJB Ch cFk A f��,st��nc7 09�� REVZP.W WTLT, B� STARTLD <br /> fSee _��__w___��__�_�^_w----�-�_ <br /> TF��APPLICI�NR'^�5 s^�(circl� one)wY 0«'N�R Qr CO�TRACTOR <br /> �z,�� '��" �� �- Cl �"�._ Z I P: <br /> Jo8 sx� �n�ss; ���� r�.-� �� h ,. -- <br /> , -- <br /> (wo rk)�'-�i'��r� �`� <br /> 1JAM� OF OWNEFt s <br /> _ ����i � t11 FRR�V���r� P�ONE: (home) ���� � <br /> MAI�ING ADDRESS:. ���` �'% <br /> �+'r�� -� �� CITX: ��I,C�'�/�,��� — ZiP: <br /> �... /.--� ✓i�- PHq�: "1"'���� — <br /> CON�RA..GTOR: �J��l� �,�� �.��,�..��.�._�L <br /> MA�LING .�a�ss:�G��.��'.� ��� /'�� c��t:. G��l�� F�-r l�l _ zza�:.�-��l� <br /> STATE Z.TGEN�R s #��.- -- <br /> ARCAZTE�Tf�NG�N�FFi.: ���,, . PHONE:�_� - <br /> ���`�"s 'L�P: , <br /> rsAzr.zN� ,�n���,:,�.��.� __.�.____ _____— — ----� <br /> NAH�: _..o�.�- ______�..�._�_.,_...-�..... �GI STR�1.7e�ON #�� ..___—� <br /> TYPE t�� P70RK: New � �dditic�n_ _ Acceasory Stz�ucture Mdve — <br /> Uemo R�modelfAl��ra�.it�n�_ Renovate� Land Altez�t�.on <br /> PROPOS�U WURK (describe 3.n deta�..7�.? :��.�'ta.F.�-tN(.� ��� -���it„�� _,i,tllrurbr�l.��'^.,-z <br /> � "� � �j I�.�l� N 1>L�t r�! r- '� i..�!i/�D�t,.-l�` Ti-I+� � L.i/N'���,!2'� <br /> y� �x A<-r �1' �+M E ��-- �..._- a,,,, -rw d r,..r��v�r�, /�L��,-�/�.��s <br /> �{` �'-� 1. ;rQ�C:/✓�csM �e/�G � [S-c�rat- ��:�- -•-�,R,u ��'/•c-�'��1 �t' <br /> T�'R/v`�c:�R+��a �V F��- � <br /> L�!I N L�c�WS <br /> �uTORYBS:�,i„�, SK2- F�T OF ISAGH P'LO01�: <br /> I�iO. OF BEDRq!3MS� GnR.A4S 5'r.RT�S a ATT. D�"'I'•,�,,,_ <br /> '--� ' ---�-'1 P�(� �1-! !l�i�iG j r i.�j �- �G D�cT F— l�.►�a f> L���i ��L F��;"' E=�Q��� <br /> �„c_'�l�l� c�� T"r v _F �'X'1 a� � - <br /> ESTIM�TEn �ONST�tU�TTaN vALnA2�oN (�acluding 1�nd) : S�--�-'�"i <br /> I hereby applY �ar a bu�.l.di.ng pr-Xmi� and � acknc�wledge that the info�ma�fan <br /> above is cornpl��e �nd accura��; �hat tihe work wa.l�. be in conformance with the <br /> ord�.nanc�s and Cod�s of �h� C:IL'y �nd wi�h �he Sta�� �uildin�' Cbde; �hat Z <br /> underst�nd �h�:� is not a perm�.t ax�c� wo�'k f.s n�t to sta�t withov� a p�xmi �% ari� <br /> that the work w9-l.l be in accnrdance wa.�3ti tla� apFroved plan. � <br /> �' �> ' � ' � .� <br /> �-�- .�ir ,, DA�: � � � <br /> �pPLICANT'S SIGN.ATUItR e - f� � - <br /> �(�Tyy`��v� �- �� N/1-� 1/�r �f� 1'�'C+`'/. <br /> � <br /> . . �P��� . . . . <br /> __________________________________________________________________________________________________________. <br />