1986, 06-25 Permit App: 00011790 AdditionDEPARTMENTAL REVIEW
I 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
Approved
Cond.
Approval
Hold
Environmental Health
1 W. 1101 College
Room 200
Application #
P & —Qcr6O%
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Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utilities
N. 811 Jefferson
Pian Review/Fire Prevention
N. 811 Jefferson
Other (SEPA/Crlticai Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
I 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
1
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- 1
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