1985, 12-24 Permit App: 00009731 ResidenceDEPARTMENTAL REVIEW
1 certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
Signature
Date 7— 75'
Cond.
Approved Approval
Hold
Environmental Health Application # g5--/q-35-
j -A F,'"a'
g W. 1101 College
Room 200 ��IA 419/ —lei / /i 5 1 le/ :.I
j%�
11Nj •
..1.1'�,r
/" 1 J
fanning/Zoning
N. 721 Jefferson
'a
167 72' de---z5-----Tb. _ ife /.re.f ,60-,.
.."--e...,z, .lir..sc.P
ISP GG
f Engineers/
//A,
I N. 811 Jefferson /-',61.1" - 727
:_ _ ,
40101.
Utilities
N. 811 Jeffersonla
I
-
Fr
iiii-i
Plan Review/Fire Prevention
N. 811 Jefferson if
riP;(//
Other (SEPA/Critical Materlal/etc.)
Fast Track/Special Inspection Information
Project Representative
f Phone
Address
1 certify that I have examined this application and state that the information contained in it and submitted
by me or my agent to compile said application is true and correct.
Signature
Date 7— 75'
.4