_� .., ��� �. .,� •.�+•••a•• � v i�=rr av� Id AJy/G4/�v ��:�6l � :ULl1l� �dU''LL
<br /> . , .
<br /> ,-� �
<br /> ,� C
<br /> � ��,��% To�l F�: �, � ��- ��' Da���ved: , ,o L
<br /> � � . -
<br /> Encsred �y: �'t�� Permit�: ,�o �oo
<br /> �� � . ���� OF OIt�IY� d �iJl�,l)I�TG �1VI�T �PI,IC�T'��1�
<br /> ,
<br /> �1� �e��or7m�don m��t b� �ubmlt�ed �m Pu�l��efore pl�rev6ew wi�1 be �t�rtea.
<br /> �, �l�ase prta��all ir�vrntarion)�
<br /> • :.......�� �_�___:_�___------_ -�._.�._�._�4..�...,�...._ _..__.r....��-�------_.._�.��__
<br /> T�IE �PI:IC� �: (clrcle one) 0'�VI�d�R 0 OA1TR�lCT`Olt.
<br /> � ro����,����: `��� rv. ^ �-�.�� �: �-�q � :.
<br /> •� L�i�►11+I�OF O�: �o r�r�_C��.��v.+�_ � PIiOI�: (hame) 9Sa�y�,..q ,�(�'0
<br /> ' (wor1�} �
<br /> N1�1ILI�1�!lD►Il�Ss '� C1TX: � �,d�':
<br /> �
<br /> . • . � •
<br /> . ,
<br /> CON��C'i'O�: ����..�,r�s,c�t��]P�t�P�: (oSl- 2cl,ow�.�i��,}
<br /> �. C�N'I'AGT�CDAJ: � 1V��II,�/PAG�: .
<br /> . � 1V��I1�G�D�3: 19a� Co�in�uRd,C l�.�s-� CTT'Yi�c�u;11t �:,`�.11'�' , '
<br /> 'b"rAT'�I.ICEI�i�: ���.�98� _ .
<br /> . �t�'I'�'.CT/FNGII�i�C�: ��NEs � � .
<br /> Mt1,�LI1�IG�]DR�3�: �'1"X: � Z�: , .
<br /> � .
<br /> Nt�A�: � Il�GESTItA'CiON� .
<br /> '1'Y� OF '�'Y()l�: New �lddition Aoces�ory Sttuc� �
<br /> , �Iove R�modcll�lt�r�tian Land A►1t�tat�on� . '
<br /> 0 � ' � . � .
<br /> ,� � �'ROP�S��O�RK(descr�be in deta��: • .
<br /> � �
<br /> r ���'� - sr��: sQ.��v�����a��: �
<br /> � � ______�.
<br /> �r � PQ(�e �F ���tVXss G�G� 3TA�LI.�: ATT. ID�T:
<br /> r.,
<br /> ;
<br /> �3"I'�M�TED COIeTSTEtUC�'I0�1'itA�Ul�'TIOAt(�ladit��la�td}: � �J �
<br /> I h�reby �ppiy �'or a bulldin�'p�rmit�d I acluwwledge th�t the informa�ion abo�e ia cnmp[eto a�c1
<br /> accutate; tb�t dae work will i� in�nformancc�►ith she ordinerice� and �des of the City.ai�d with
<br /> ' the Stat�Buildf� Cods; that I un,dea�tand thu� is twt a perrnit�nd wotk i: not ta stagt wir�out a
<br /> . �er�it; and that ibe wor�c will be �n eotdatuce w�th thc approeed plan, � ,
<br /> ���A►�'� 3Y(�NA�'L1� �� l ' (� •D
<br /> 1V�7'�! ,P�d�f��e1►ents r�sgt�re,te�r�ate pen�lt a�Fro��l by Poltct Depa�bt�ei�t mtd
<br /> �ft,� Coa�acil 60 daya�te�bo,tla�evertt. 1Yvn�ermtlt�d eveirf.4 w�ll saot e al wed.
<br /> . ll ���,q -
<br /> C�CC �-o c ss,�- �Y- ��-� Z /--_
<br /> £/Z ' dR,�09Z� ' �N�;�,� �.: �a . , ,'��►o�r n_:_, T:__ � . � �WdBZ � ll �zooz '� � aay
<br />
|