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J <br />0 0 W � r <br />UR 10 <br />APR 12 1991 <br />RETT <br />EVERETT BUILDING DEPT. CITY OF EVEDate: <br />Public Works Dept. <br />To: Hen Edwards, Plans Examiner <br />Re: Owner's Name: lglf"h'y/N ��l?LOtF <br />Project Address:/Gc /Fmvr 4Vt£. Y <br />Attached are Repair Specifications for the above mentioned <br />project. Please provide CHIP the following information by <br />initialing the proper box: <br />YES NO <br />Plan Check Fee Required: I4 �� F7 <br />a <br />Please return this form to CHIP as soon possible. <br />Thank you. <br />CHIP Staff <br />cc: <br />��nI�SI F%I%1z�0 j A 3 uNrt" bpi ° 5; 9b4i,-fALj^l4at,,l 1N� �lon1 <br />t7,7'' 6,63Z 'wPTE; c4.•2Z-72 <br />A$ <br />