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I = <br />i <br />DEI'/:1:TI.11:1JJ VI' 4lll"II'1UNJ.I III'.V1:L,VIYvI.i:l <br />n1171d771:G PEW'. T AIPLICATIOI; <br />DATE •• <br />ADDRI;FS OF CON::'rRUCTION 140111: <br />LEGAL DESCRIPT3011: LOT dL,OCJ: <br />UNPLATTrD t)M"i:1PT10 <br />VALUATIOW <br />PEIUd1T 1''LL <br />PLAT l: r.-r- T-1, rRs* <br />REMODEL <br />BUILDING DrSCRIPTION: <br />NEII <br />ADDITIO:: <br />OR REPAIR <br />C OF U147TS <br />OCCUPANCY OR USE ""^ <br />STORIES <br />IS THIS A CHANGE OF BUILDING <br />OCCUPANCY: YES <br />NO <br />CONTRACTOR 'T177- <br />''ll1:1 <br />T111.Oti1;1;Jt <br />1470LI.I:G <br />1.1AIL7P.F <br />ADDRESS <br />ADDRESS <br />_ <br />PIIU::E NUMBER - ' PNON1' NUMM JZ !� <br />CONTIU.CTOR'S LICL'I;S Iti:•:L'L:II - __ <br />S1GNi,TUR? —e 7 Lam• '�' ✓. <br />NOTE. Till: 7.T,'),1C..L^ r!. FILI, ?i. ALI, LP,(%\'i'. ItL".':'.. COMPLI-TI:1,J' INCLUD'I",-, <br />Till; ILOT MAI, r.i"i 1, 0 }..... C.111TITV rjj".i'j. is 1'.'I'LI u:T 1`.' R..SPOL. J I•L <br />VOR ALL I1;PO:"'' I ON I•LJ I C11 1 S i'lii',':1 F.::::D U:: Ti:': 7111PI 1 CIfTlOI:. AM CAANG:::; <br />IN 91111 I1;1'OI; S,i':':I O:i I'i.U'; i'l,il:: U': l Ui l.l) i GI' t Lt,1;S S1,.1.1, 13L SUPMT^TED TCI T:1V <br />INSPECTION DIV7SIOi; 17OI: 7'.1111ROVAl, L!'E'01:1: Pl:0:-I;-MIN WITH THE CONSTRUCTICi: <br />I�OR1:. <br />APPROVAL, <br />1. PLATZNI14G DATF <br />2. rNGTNET':Rl:::' <br />rIL1IT'iC <br />WATER S1I;VICE I <br />SEWI:1; SERVICE <br />PUBLIC SERVICE SECTION <br />'•. INSPECTION bRPARTI•IL;NT <br />4. 1111' IUIR511AL ---- - — - ----- - <br />NOTE: ALL CO::F:TI'.i1CTI0:1 I' 1,1: :;11 ,1./, CO>IPI,Y WITH A1`111,1CALI,E CiU?C i NOTE: <br />ON Im,wir4GS, AND INSI'1'i"1'IOC± <br />-7S-ZZ �p <br />I <br />