1981, 07-02 Permit: 81A-2828 Inspect1PLAR Nu1N811
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AODAMIE
LEGAL DESCRIPTION — SEE ATTA
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I hereby W1bty that I have lead end ellaineied hills applll.ahnn and hive ,,•n,1 the "N(Ii ot, omosnr l,nle,l
e : .,, alae, nod know the same to he and owlet t All sl rl law.I , .. ling ll .
type of
work w01 be emptied with whelheI spechfted heteal Foo In ,t nl evn,nr
10 give authority lc violate or Cancel the po wm001 01 any nlhet 1101• I„ al law ,etPn„ h, o, „nucupn r„ nl,
motorman°. of conatructlon. SEE REVERSE 810E FOR REQUIRED LNSPECTION¢'y
o A1E or AroLICArION...,l .L.^*. 0.r/ ._�._11GNP ILIuw
SPM.IAL APPROVALS
NAME OAT°
IPS AL CCNSOT
ejaiat4441. Xtirl rhCLSC.,
Snare
Bunting
Plumbing
M•eh.
Plan Check
BEPA
Moen• Ham•
TOTAL 8 If
•1100
.1100 E
.11006
•000 S
027*
{.3-27—Ai
a 6479.
INSPECTION RECORD
ADDRESS
DATE REDS
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