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1984, 05-03 Permit: 00000645 Residence
SIGNATURE OF OWNER OR AGENT JOB 17E14 a e ALQ 1 N P..D . OWNER: --11. ?'t r2 i NC.,, ADDRESS: CITY: �/ ^�y� j�''` ST: ZIP: APPLICANT:v CONTRACTOR: ADDRESS: CITY: ST: ZIP: PH: LICENSE*: ARCH/ENGINEER: ADDRESS: CITY: ST: ZIP: PARCEL*:�� CSC.` • 46la CENSUS TR: INSPECTOR: PLAT*: LOT & BLOCK Lib $LC) FINAL PLAT NAME: tx rnntEe Ft -d Z S 7" ZONE*: ZONE FSB S-1 5-2 RSB MOD USE OFPPERMIT: 24 (CDCs NL`E JOB ADDRESS: APPLICATION DATE 072/ 5E0. s: DATE:`� PROD` FEESy PAID BY: CA C3 CG NC COU N1iRH P? PLANS EXAM: D/A" .60 r Com, i IFALii y +mac T121 cr OFFICE COPY 39212 *306.0OY