Laserfiche WebLink
� . . <br /> � C7 q�y. rn; _;;I;RET'P PliIL�tIT N0. _ �C� � � <br /> ;)]iPAP.7F4rIv'1'�OL' COh1i•iUNT'PY DE\�FLOPMEidT VJILUATION . <br /> 13UI1�:?IIdG 1'Ii1LiiIT eIFPLICATION p�IL�lIT FL•'E � SZ� <br /> DATE , � /`� �� r <br /> l' �fI it/�-I /�� � � L I/,� <br /> ADDRESS Or CONSTRUCTION ��D.- � C� � / , , <br /> LOCK � <br /> LEGAL DESCP.IPTION: LOT ' PLAT ! L�J <br /> � UNYLATTED D�SCRIPTION <br /> " / / R��fODEL <br /> BUILDING DL'SCRIPTION: NEW // �DDITION OR REPAIR <br /> � �� OCCUPrI\CY OR USE STORIES 7/ <br /> # OL' UNITS , <br /> IS THIS A CFIANGE Or I3UILDING OCCUPANCY: YES / NO <br /> CONTRACTOR �����' OWNER �• C/ ', <br /> MAILZNG - \ b;}�ILING '� L _ <br /> AD SS / �� ' LJ� . ADDRESS v � '-0Z'�, <br /> p� � 1'4 <br /> -'Y�-p �(/ � <br /> PF30NE NUhiBER J� � a ' �3� / PFIONE NUPIBER �nJ 'l � ��S � <br /> CONTRACTOR' S LIC�E� N 1BER �L ' '� <br /> � �. ' %' � <br /> SIGI�ATURE � -� / <br /> NOTE: TH� APPLICANT SHALL FILL IN ALL ABOVE BLnI:f:S CO:1PLI:TELY I21C.LUDI�G <br /> TIIL PLOT PLP:I� Sh�TCA 02I REAR OF THIS SIIEBT. TIIE APPLICAN'P IS RESPOI4SIBI�E <br /> FOR ALL INFO�_�TION I•:HICII IS FURNISHED ON THE AYPLICATION. ANY CIIe�NGES <br /> INSPECTIONODIVISIOi: I'ORlAPPROVAL BEFORENPROCEEDIP:GA7ITH�TIIE�CONSTRUCTION� <br /> WORK. � <br /> APPROVAL: �� C� <br /> 1. PLANNIrG ! � DATE -�I- 7 <br /> 2. F.NGI,�EEF.ZNG '� � � <br /> Tr�7�rric —�io�a <br /> C '�� � `'�� — <br /> {�t7�TLR SERVICE '� �^3-7cf <br /> SE�9ER SERVICE —* T <br /> PUIILIC SEP.VICE SECTI N -7 <br /> ? INSPEC 0 DEPAI2TDS�NT ' �—` / � <br /> �- �/-7y <br /> � T' � � a� ��� � 4- _ <br /> v <br /> 9 . FIRG r;ar.sx�w <br /> NOTE: ALl� CONSTP.UC9'IOiQ WORf: SEieILL C0�•iPLY S•]ITII APPLICABI,i? CODE•`� , 1''•n7`!:S <br /> ON DR71S'7IIdCSr �1nD IKSYEC'PION: t �_ ` <br /> �`��.z��� /3nv.�� N � <br /> f2.�/3/.tiso� ��L/`��� <br /> r � <br />