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TodAI�'�ee: � 1?ate�eceivQd:,.,,_��_��___._.
<br /> P:ntered By: �� Penmit#: ._ .. - — ....,.._._.,
<br /> CCITY �F CfRQNC? -BU�I.�.1I3�1G PE�MIT A�FLI�`ATICDN
<br /> ,A1!inf�rm�tio� �nust b�c submittcd in f�all befare p1�n review veFllll be started..
<br /> (Ftease print all injvrmat�'m�)
<br /> �'HE_�hPl'L[C:�.NT IS: (ct«t'e one) OVYl�1F,R R�:`ONTitAC'�''0�2
<br /> ,It�B SITE A.DDI�ESSv ,��.-�...�...��.C_._...��-�._.._. ____�'� � ����—
<br /> ,
<br /> WiIE i�is be a�'arade of�do�e�, Rennoc�el�rs Shc�vs�se Horne�r r�ther Di.rplay Hom�?
<br /> [��X�s E��.�TO If yes, a specfal�venP�ermit is r�qaaired y�ith Pv(d�e Lkporlrrrenl artd�'ity Cvtr»cit�z�r��rnv,c�I
<br /> 6fl c![1y.��?rfor!a the¢vend S/n�rr�e bus,seyvice will be requ�r>>d senles�s crppilcant d�r�aurxsermes
<br /> su�cient on-site parking is availahle. �ti'ori-�,aerm/tae�t ev�at.�wil!nw e5e all�:r.•.od
<br /> NAME O�4V�'NER: �_C�_u��i��s -� �j t`'(���c'�P�IONE: {hc�:ne)�����''?��
<br /> tw�}.�:LZ.:�.'y5'�/
<br /> ;�IA,II.,iN�AD17►KE5�: ,,,�?.��_��.��:%�'� ��'._C1'['Y: � ���. ����I�': �-'� .
<br /> CO.N'Y''RA�'TOR: ���,'�`L.> P�UN�:• ._._.
<br /> COl'�iTACT PFR'SON: _�_�� _ P���J►�&IL�,/P.�GER:
<br /> NiAIi.P.�it.i ADDR�;SS: .______--____.,.�_...._____ C�7'Y: -- 7�': �-_______
<br /> �TATE�I�C'EN�E: #_ ...._._._._.. �XP%12.A7'[�l"�bA'�E: __ .�._._._._
<br /> A►][�CHiTECT/ENGINE�R: �_.,..._..____. 1'H�?1�F;: __._ ......__._...._...
<br /> �N�A��..ING,�DRES5; .�._..__...._._..�,,.._...._ CY'i'�': , ,ZtP: ___�_�_...�
<br /> NA►I�E: _.._. ______._.._�RE,Gkfi'I'�tA'I'tt'��: # _______�..._r_
<br /> TYPE UF�Vtg12K: �ter+v Hc�me .._ Acidition ,��ce�s�ry Structure �
<br /> Move���oma Re��x�ie[iA�ter�tyan �ie� Slding, Windo��s) _
<br /> x
<br /> �ny earth mcavement. mr.3y r�q�ii.re M�� x�ev�,�w �n�a p�rmi .e!.
<br /> PR4POSED''�dO1�,lK(d��cr�ibeln detait}a ��' w_,....�1�..�__����''�_'�.��'.'._.���
<br /> ,�..,� � n,��.�.�.... — _ ___.._...____.__. -_._._._._______.__._ _
<br /> S"�'"CaRIESc._� S�2A FEE�'OF�.�.�."lFI�,C.1��:,�,_��_- -- --_ _
<br /> :�i0.CiF AED�2QC111�S: Gt+�RA�AGF S'�.AL,GS: A�TTA�HE� D�:'T�Ckt�ll�
<br /> ��
<br /> E57[�tv�.ATIE��'�1�t5Tl���t�'i'tt�1�u��,t1AsTId�N(excluding l�nd}� �.-���`....�..w.._...._..
<br /> I lhez�eby appty fc�r a huildeng permit and�ackn»e�rlyd�e that the infc�rnyati�zn akrov�'rs ccrmpl�te r�s�d ac:,=�r�te;
<br /> that the wcrrk will be in conforn�rsce+xith the or�inanc�s�nd codes�?�ii}�CYCS/$i]i�WI�PI IhC SttiB�BUlIL�.1iS�
<br /> t',ucle;rh�t f nz�derstand tt�as i�nat a E�,7mit and work is not°,n start w�ithc,ut a p�rrmit;arad thaf.th�w�rk�71!Me
<br /> in acGorda.nce with the approved ptan.
<br /> ,�
<br /> .��'}9�.ICtL��s�l��t��.,��: '" -' � �l^»1:�-[,+'�.G� �'��'l: ,,,�..J.Y.L.�..._.�'!��
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<br /> 31
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