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CHIP � <br /> � � � �,-�77� ,e CITI'Of= liV'(_RI�: I f <br /> � �� � c�' COh1;�tUNITti' HOUSING 111PR0�'E:AtENT PROGRA�t <br /> To Plans Examiner, Bwlding Department <br /> �'AY ,. <br /> � � _ <br /> From ; ��,,� `, ;, �� � „ CHIP Staff : <br /> � <br /> Date ,�:--, , <br /> RE� (� �� ;;� I , � [, �- Owner's Name <br /> ."/ / l % ; c /r - ��L �1� r . Project Address <br /> Attached are the Repair Speci(ications for the above mentioned project. Please provide <br /> CHIP the following information by initialing the proper box. <br /> Yes No � <br /> Plan check required: <br /> ❑ '✓ ��z�//� <br /> Please retum this form to CHIP as soon as possible. <br /> Thank you <br /> � I Il nl I.\ I.kl. l l <br /> _�l:�i \\.'lI1L�ft \�Cr1tIC. tililtc• �IIU • ��.�i'li•II. \\ \ �1�'ill �11LU <br /> �.1'�� 'G'.\" :i . �-.�\ i1'Gi 'i7.\h.S <br />