Laserfiche WebLink
� � �yi %�. � . <br /> � � �vzr,nl�ac r�:rr�tiY�r n��rr,Tcn�rr.ow � J ;.� � _ . <br /> • �1ppl.icant 7'o Com��].ei.e 7`hie� l:'or.m . 3���{ � <br /> If mor.e L-han one Uui..ldi-ng is� to be consi:ruc:ted, �ubmS.L• a sepzu'�ite per.mi.0 <br /> appl.i_cai:i.on f:or. cach building. A sc�p��-ate per.ntS.0 �•rS.7.7. be issucd f:o�- c�1ch <br /> bui.ldiny. -� �//9 ��,_/' <br /> Owncr �u./� J C� /VL� � Pui1.Qi.ng Ac d�-cs�-���Q'�c���a.,, <br /> Rddr.ess '/Ov 0���� G��__-�.� / Lot �--�— 13J.or.): � — <br /> Ci.tY �Ut's[_-c�c� Phonc �� 1�`/ Subdi.vi.si.on (Plat) cT'y1v.r�.l�i3��L <br /> i <br /> Isrchi;:cci:/13ngineer �G��v�'� , __ <br /> City =- Phone -- 1,•�t:es & ]3otinds (Un�'�latted) . <br /> i� � <br /> Con�racLor `j�1}�'-.. l�,=-� �/<'y2`-.-r Scc. T.wp. _ Pqc. ._____ <br /> ncldress ����,-��— — --- ----- <br /> City - Phone -�— --- — -- <br /> � <br /> State I,icense humber Z Z�-�O/–%C„��� –� . . <br /> Lr.pirati.on Date �/�Y i�' _ � _.— <br /> z�U�.�.a�.�,�� vs� ���-:1 <br /> Descr.ibe t•lor.l: to 13e Done ,Jj �t-%. , <br /> �� ,c.c._ <br /> �-��Lj _ �-- - <br /> co�-T�r^i PLOT ?�Ln�,T oai ttrtt��z�r sm� <br /> _.._.�__...�..______..�_.__._.._.._ Nwnber of Stories ��.�z<..`. /f� z- <br /> T <br /> Basemeni� -- <br /> . . , l�e�o Tiddi.L-i.on Jtepair./Remocic]: <br /> ; Valuation of Const�uction $ _ <br /> . Signed By -- — . <br /> � Por -- --- <br /> O�,�ner Pho�1e � <br /> Do :'oi. Ydri.i.c 13e1.o�•, 'Ph9_s T�.»e -T7or City i)se On]y _ <br /> llaCe Feceivcd '����'7_ . . .� Use Sone ._ ' � <br /> IFa.an Checl: P2um)acr. 7!n/.S`��/O�J rirc .'/,onc _ _ —. <br /> \�alu:ti.on f ��� � Occup�incy �Groul? --. . <br /> Pei-mit� 1're i `�2� ; 'Pype of Consi.r.uci:ion ------- . <br /> 1'lan Chec1: Pce "'�— Occu��ei�it: I,oad �__._._ <br /> lCotal I'ec Due /"� . Od .� Spr:inl:lers Requi.�-cd ----- <br /> llat:c ls;s?ted _� _ <br /> t, - <br />