Laserfiche WebLink
cl�r5� or rvL�.3,T.� r�,zriz7� rro. 5/� <br />DEPAR77•;EI�T ON CO.`-lidUNITY DFVI3LOPb11;NT �� ���y <br />13UILDIIdG PL'Ri11T i+PPLICA7'I0:1 VALUATION �c9t7 <br />nn`I PER29ZT FP� �� <br />D71TF _ �, . � � `'I ' /'^(' <br />I�DDRESS OF COI�STP.UCTION P70RR ,� � R I�� oy:_, � ___ <br />LLGAL DI:SCRIYTIO\: LOT <br />BLOCit <br />M�il�Tll <br />UNPLATTL;D DESCI�iPTION F �p �oJ� (1,�-p'_�� � d� �Q�� �Q 5 8' �( ��CiR`Q <br />P�_" �' <br />�� � �� �ns..i'�� n�v. nra,�-0 f � ' � � E� � <br />�, Lx�t� r Ot�- (.l�<„o aA v)� ���n c� i hac rL e��,, <br />� <br />RI.DIODEL , <br />IIUILDIIvG DESCRIPTI0�1: NEW ADDITION i <br />OR P,EPAIR � �n�0y� <br />;� OI' UNITS OCCUPANCY OR OSE STORTES <br />IS Ti1IS I� CHANGE OF IIUILDI�� OCCUPAD?CY: <br />CONTRACTOR �( � �Q-Q�\�lu� <br />i•IAILING <br />I�DDRESS � � � ,�� <br />�� . <br />�- a-� �� � . <br />Pf10NE NUI•7B�R ����� � � � � <br />CONTRT�CTOR' <br />SIGI�ATURE <br />YES <br />NO <br />OT�7N�R �. � <br />NIAILING .� �� <br />ADDR�SS <br />90 _T � A��IL: . <br />PHONL'' NU!•IBP'.R �,�J� — `7O/o� <br />NiJA1BER �G�J-C�I ' II"�o� c� -- <br />tdOTE: THE APPLICANT SPIALL FILL IN ALL ABOVE BLANKS COt•IPLETELY INCLUDING <br />TiIE I�LOT PLAN Si:ETCH ON Rr^,AR OF TIlIS SHEET. TIIE APPLICANT IS RESPONSIF3LI•; <br />POR ALL IA'FOR�I�TIOt•i F:HICfI IS FURNISIIED ON T1IE APPLIChTIOn. ANY CIiANGES <br />IN TIIE I.1FOR'�ti1iI0::, PLOT PLAiv' OR BUILDING PL1NS SHALL BE SUBD1ITTr^ TO Tilr <br />INSPECTSON DIVISIOi� FOR APPROVAL BEIORE PROCI:EDING I4ITH THE COi�ST12UCTI0`: <br />PIORIC . <br />71PPROVAL : <br />1. PLAN;dING <br />2. r^IGI,dEERING <br />'.l'RAFFIC DIVZSIO� <br />ti•;ATER SBRVICE <br />SEL9ER SFRVICE <br />PUIILIC SEP.VICE SECTION <br />4 <br />IhS�'LCTION DEPARTh1ENT <br />rIP.li I�1IRSHAL <br />DATE <br />P:OT�: 7�LL CO::STi;UCTIO:? T•;OR?: SiI;1LL CO:iPLY j;:CTfI I�PPLICALiLE CODFS, NOTES <br />o�� nr.;,,;r.:cs, ::::n t::�:�:�.�n;;s <br />