1980, 02-25 Permit: 80-510 InspectEar
APPLID4N1 1.1!POH
E
ACO PPLICATION/PERMIT
PAgTMENT
Nur
DATE
1 'oE r5oge i8 / E
SUZ
CSI Orr Okle.MZ IYJ2'ffC��ToAR, 2
I SDE 657
2
RpP 169s3W3 bA -rte IS9tO
9%z
LEGAL DESCRIPTION — SEE ATTACHED
PnF<E —"E 'sea 52�13a I
5 1 51 et—mo, 2.50 oR W 24U
e.c....s s., re -3°D
PiriONE
�9C0
w. DNe o
CHANGEOF USE resin
9 :AI AItA8 HIiA�b ('-4 aiN,<
""rete..
noon I N. Rooms
•
Fin Rees"
CERTIFICATE
PIEXEMPTION
SEW ER
FEES COLLECTED
hereby [oddly n na nes Riad Ore 'rw TLE•
pc reverse w the slAn, 10 .hnun and CO, et All stens 01 laps and .nninernne sevennns nu
type weds side
mPlred w Whether rtp 1� Tnn 9renline DI r d dam nor piestime
IDfp,
pre rr pence! the prwmmrrl pl a sD ION slate Or IODS aw deeWaenn<nn:.rvninne Ore
TEpelf
D (-/6'6'o S, A
SPECIAL APPROVALS
118
M�II, Ta owry
PI Ch k
WAD
74 00
mmd lys,ryl ��
.,xEw.e<apLlpnr.o�;/..a37so--
E
347
01-1£-9
+ A4,0.
INSPECTION RECORD
` 5
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W FINAL INSPECTION: r/ to
SET BACKS
DATE REMARKS:
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s---T, g -r> C eRMI etc-
/ / / /
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d C f75. -e is r/ t 5 if/al ,, �� /
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