Laserfiche WebLink
i <br />d <br />� Cl:vo OF i:VCT;I:TT <br />� nrr���,s•�raa�r or co�a:•�oraT�rY D�\�TLOPMENT <br />�nq7LDII.G PJ41:f4IT Al'1'I,TCATIO:v <br />^AI�TE / ' � 0 <br />ADDRESS OF CONSTRUCTION WORK a/_�,_� <br />L�GAL DL•'SCRIPTION: LOT L'�_ i_J IILOCK <br />UNPLATTED D�SCRIPTION <br />AUILDING DBSCRIPPIUN: <br />� �i ��� !�-2S� 5 <br />NEi� ADDItION <br />PliRtdIT NO . � �� � 7 � <br />9�VALUATIOi� DO. —� ' <br />P1:i:;:IT 'r'L•'E .'�.- � , <br />PLAT <br />R�h10DEL <br />OR �'� <br />j� OF UNITS OCCUPANCY OR US� STORIES <br />/ <br />IS THIS A CHANGE OP' RUILDING OCCUPANCY: YES �, <br />NO <br />i ��/ � <br />CONTRkCTOR %�d����'--i'� OWNER /� L�� i-a <y--✓ <br />h1AILI\G biAILING <br />ADDRESS ,��. i�c � GJf}SL']-_— ADDRESS �� L �'' �����_ <br />PHONE NUr1BER PHONE NUriBER �� �1n7Z <br />� <br />CONTRI�CTOR' S LICENSE NUI3BER �'" � � �g�� <br />SIGNAT Rr � ` <br />""" � LL FILL IN ALL ABOV� BLANKS CO;•IPLETELY IIdCLUDING <br />NOTE: 3iE.APPLICAN <br />TIi� PLOT PLAN SRETCII 0\ R�AR OF THIS S}IEET. TIIS APPLICANT IS RESPONSIBLE <br />FOR ALL IkPORi•:.=�TION [9HICII IS FUP.NISFIED ON THF. APPLICATION. ANY CHr�NGES <br />IN TF1E INFORf•SAiIOI�, PLOT PLAN OR BUSLDING PLANS SHALL BL SUIIMS 'TED TO 7'IiB <br />INSPECTION UIVISIOid L'OR APPROVAL BEPORE PROCELD1hG iY1'lri i'iin • STRUCTIOi� <br />WORK. <br />APPP.OVAL: <br />1. <br />2. <br />PLANNING � �� �. DATE <br />�t� � 4 C.AIJ <br />ENGINEEP.ING <br />'PRAL•'FIC D'iVIt3I0N <br />WATER S�RVICE <br />SE�•7ER SL'P.VICE <br />PUIILIC S�P.VICE SECTION <br />?, INSPECTION DEPART�IENT � <br />q, FIR� t•IRP.SIIAL <br />NO'PE: A7�L COi1STI:UCTIOid C:OI:i: S[IALL CObiPLY �aZTil 11PPLICAI3LE CODES, t•:or.rS <br />ON DRi,[•IIidCS, 71ND ZIdSPGC'I'IOiJ: '���_� c �� f,'-_ �� .pCf�r L�ti /�at �'�"""/ <br />72�c/� M� _ ' / i <br />iLcL'J� 2o�G f+�.....� �Yt+ <br />✓ <br />