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0 <br />CI'!'Y UP 1(`Ji;RI;'C9, <br />III�:PAf2'P61Ch;'P CP COt�1'�:i�::l'1'Y llGVI.LOYPICDIT <br />RUiLDIIdG P1;iif1l'1' APP1�[CATION <br />���,-���. s'- l �� �� — <br />ADUI2ES5 01' CONSTRUC'i'I:ON WURK <br />�� <br />i,liGAL DESCRIYTION: LOT s <br />UNPLATTCD DI:SCRIPTION <br />P1:1:'.dI7' NO. <br />VnLU7�TI01d y�' <br />,_� �„ <br />�� <br />P1's12IdIT 1'1;13 ��� <br />BLOCK <br />13UILllING AI?uCRIPTION: NE�4 _ ADDITION <br />� OF UNITS OCCUPANCY OR USG � i:' <br />IS THIS A CIIANGE OF llUILDING OCCUPANCY: <br />/� / � <br />CONTRACTOR L -- • <br />� <br />MAILING � ,. �.i� <br />� ,� , ' � ' <br />AllllRESS ��-� r _ <br />�� <br />/; � ., i � ��j � — <br />n�;nUr. unMnr•.n / ', i� . � <br />YES <br />0[4NBR <br />MAILING <br />T�DDRESS <br />PHONG �UMB�R <br />,�� ,' /� iy / �� <br />CONTRIICTOR' S LICEt�i� NUMDER ,� . ��--- ;C.,/ <br />i , <br />�i.. / �' '�. <br />SIGNATURE � ��•-- - <br />�� <br />NOTP: TtIP. APPI�ZCANT SNALL PILL IN I�LI, AE30VE IIIJ�NKS COMPL?1TPLY INCLUDING <br />TIIL' PLOT PLAC7 SKfiTCII Oi� RET.R GI' "PHIS Sl11iliT. TiIIs APPLICAPI'P IS RESPOI7SIRLI's <br />FOR ALL 1Nl'OItM1fAT70N WIIIGI IS FURNISIIIin ON T}{g APPLICATION. I�NY CfIANGES <br />IN Tllli INPOR�SATlON, PL(�T YL7�N OR DUILD7NG PLANS SIIALL IIL: SU23MITTI;D 'PO '19iP <br />TNSPECTIOt: UIVISION I'OR APP320VI�L I3EF'OP.E PROCL:liUING �9IT❑ 79IL CONSTRUCT70N <br />woax. <br />PLI�T ����„ � ` ' �-. <br />RLMODSL <br />OR RGPAIR __ <br />s�ro�air•.s _ �' . � <br />_ NO �_ <br />)�PPROVAL: <br />1. PLANNING <br />2, SNGID]EPR7NG _ <br />TitTPI'IC DIV7S10N <br />��'ATI:R SERV1Cli <br />SIiWI.R SERVICI: <br />PUBLIC SERVICR SECTiOi� <br />. . INSPECPIOP7 DCPARTMliNT _�_�� <br />4, I'IRL t•tARSt1AT. <br />nn�rr <br />N07'1's: AT�1, CONSTRUC7'T(lid W012Y. SIIAT,I, CC�>71'I�1' l�']7'll APPLICAI3I,R CODIiS� i�10'I'I�;S <br />C;J DItAl9iI4G1;, Atl[l l I]SPI:CI'IO:d ; <br />