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CIi'r Oi EV'6�r1�=TT <br />� I f:�Pcr i IOi! llLP,'�.i;Tl.<`(J � <br />,,SUSII�'G i' "���:`/A71Gi�1 AI�'D <br />BU I Lu I i'G AI?Nl Ef:ciJT <br />�7 <br />i�;v�sris�„��,,, ..::�o:,�r Fo:;�{ <br />Part I <br />Property Address �[;�L 'F ��'�2 2 /7�`;= <br />occupancy � � X t=b <br />No, of Nousing Units � <br />No, of Stories � <br />Ra:D F-R�r7c 9.�,D �R/C� <br />ConsirucCion Typc _ <br />Base:rent: FuLI �� Partial <br />Concre[e !� Dirt___ <br />Oti�ner's Nnme f-�+l•L�� �'��-�,�%� y����n% – <br />Ouner's Address �S/;i4�= � � <br />� '� <br />Census Trnct C' Block No, C Z <br />area �F.�rcn� r�-��,v�ss <br />ComplainC2 YesL/ No� <br />Drite %–�-� –iv 1'ime ?�3U ��( <br />Inspector(s) ��i i�_ � I:�� �p�=+✓ <br />Par[ II (Complete this SecClon for Sub-standard buildings only.) <br />Housln�; Unit Lnformation: Legal Description: <br />G <br />U.U./Ap[s. Vacent ' Kroll ltajor _ Minor <br />H.K. Cr.:ts _ VncanG Lo[(s) ��� Block ��i <br />H.K. Rooms Vac�nt • Plet i��= �✓�Yta i� ______ <br />Gues[ Rooms VacanG <br />"Unclassifiable" Vncant <br />Housing Units in Celiar L/Yes �No <br />6uildinp Data: <br />Year 6uilt Siae of Bldg. <br />Occupnncy indica[ed on most recenC <br />Bldg. Dept. Permit _ <br />Pcrm?t Nwnbcr W [c <br />Prcliminary Classification <br />1L/ ZL/ 3� 4L/ <br />Final Ctnssification <br />1�/ Z�—/ 3L/ 4/ ` <br />Subsc��n,:n[ nc[ion: tiune <br />Volume Pag <br />Parccl Descri�[ion: <br />Parccl is Zon2d ,r,� <br />Dimenslons of Parcel 2� X � Z U <br />Assessed Value: I..ind <br />Date Imp. <br />Appurtecv�nt Struc[ure: Type <br />Sizc x CondSCion <br />If pnrcel con2ains more thnn one principal <br />building� Lis2 addresses of othcr such <br />buildings beLos+: <br />I!ouain; Codc AcGton: <br />