1981, 07-30 Permit: 81A-1143 InspectIRAN NYMPAR
t
APPLICANT: COMPLETE NUMBERED SPACES - PRESS HARD TO MAKE 3 COPIES
ADGR
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!VISION
a II. i•[oits.Gk-r2s
of tsoz71%1K
COq�NTR�A�yLe-T�9�O _
irDES
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aJj9� Oxb
LEGAL DESCRIPTION - SEE ATTACHED.,�n
P uNIBER/S i 54I - 0779 (Yat ,,7
N J Y� aF rJ V1 Gjc
Act In Feet
NorActual Set Becxlsoutn
PHONE
ZIP
yy� conB.
S InkINM
Ovas ONo 0 Reg'[.
.r
O°"1.f."4°,6.
PHONE
Valuation
ADDRESS 41
°SANDE OF USE FROM
6.
ZIP
Floor
Bonding trea to Sp. Ft.
yam $ 1 081.1120 Area 1Storage
TO
Arita of Docks
Flnlmed 8.18.11.11011.1
Donn. Basement
E or~BN[w 0 ALT, 0 AD'N. 0 �RPL, 0 neve. °T"'"'WORN BLD. 0 MAIN. 0 reamBM.H. 0 POOL
bESCRIBE wORN
No. Bate$ I No. Stories
CERTIFICATE
of EXEMPTION
L 1�� E OAS ��'
VA fr TION ons Cr
oiC ‘C4;7:01 ,w t
[num. DM.
Loudon (Aril
No. Rooms ro. of Dwellings
"TA'Rec e. r., Rated.
SEWER
J USE CODE
J uTILITIHs PubiN O Private EI
1 hereby certify that 1 have lead and examined this application and have read the "NO DI included
on reverse side, and know the same to 00 true and correct All provisions of law, a .nr e: govering this
type of work will be Complied with whether specified he rnr r tin. granting of .i � � does nor presume
m, p
to -live authority c to violate the SSIDE of any UI Stale S local law rag, inhl unstrucunii :n the
peAPtlpEnce of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS
DATE OF APPLICAI100 _ 4/ 6/arr _ _ Su NATURE i,r APPLICANT
Ownership
SPECIAL APPROVALS SPECIAL CONDITIONS:
0"A" DAT' Wray rt.A4t4tria, Apr-I1�7]Nii'n�! Ho c>I ocpp. �I lo( r A �c��G BYO'
/G/sf VVi'rJ2�Gw' C � ` �KA y0
Ve14-4,,a," lVtJ 94'80
VhRIAFJCI!
LtAikt, Ct95 1Jcl ATS ln�/
FEES COLLECTED
Sinai E
Building
Plumbing
Each.
Plan Check
IMF*
Mobl Mom 1aD•6'o
Other lSpsdRl
TOTAL $ IQ
07. .10000
•10000x6
•100000
F •000',8
39634
04-24'-R0
d 6479.
WHEN MArinN$ "A n IN I In, .I ACF
ADDRESS
DATE •
INSPECTION RECORD
REMARKS
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