1980, 12-15 Permit: 80-563 InspectAPPLICANT: CO
JOB ADORERS
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MEIERED SPACES - PRESS HARD TO MAKE 4 COPIES
LEGAL DESCRIPTION - SEE ATTACHED
PARCEL omeen. 7,744,
ALL Ler - SEL9 /014.071p-i3m'7
PRONE
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••• ADOESS
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DESIGNER
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CERTIFICATE Ntil. I .11. 4,
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FltePlif•!Mi. oiCiAGT.' 0011. 0 ROL '11100111.
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ID !Idler
• olooman,
liesalsylpetify that 1 have read and examinad.this application and have. react.the,!'NOTICE" provisions included.
i)71▪ MiNSWII
VALUATION " 1
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01. gm, •migiA.nd kn.,. 505 to b...tsug and Emmel. All provisions 91. laws and ordinances 11lfl5 IAN OulkINE
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Viettorpserteei,l Igi,idNeroiyron.To
of gomplied with wherliat specified wain or`not2 Th .1 granting of a permit d_..oel_not179,rne
to give .out sm-oranto.thalsioraiofircapKoorrtoor.aVmow.. 50.1
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..NFEOI`AL
FESS COLLECTED • •
DATE
*02* -;.3:).:00. •
.00•
5621 5621
0
'1
1 •
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• -71,— •
Flr•Elanlyl•
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• Po -e 4r.„5,112 -
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0. •.
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• I INNEN MACHINE VALIOA TEO IN VACE.
5.4 Sg 0.1.9, 0
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SEPA
.Ead•CIED•NR-• 00050011
TOTAL
ROLAND CRITMP
' OWNER
SAME
-
•
TWO Fili7.RtsA,,Ec. 1
.I-NSPECTION RECORD
E. 13110 BLOSSEY 274'25-44
CONTRACTOR
I
N55 s k3r30 w30
LOCATION
POOL
SET BACKS
TYPE OF WORK
FINAL INSPECTION:
REMARKS:
\,-
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