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1991, 04-26 Permit App: 91002114 Reside• U4 -6.a au= 7 3ccc ( I 1, 3/t- 9 e e. **********************************Jg**,*************************lc* ************* * INFORMATION WORKSHEET •* ****************************************************************************** • PARCEL NUMBER .gsot STREET ADDRESS: 1501 N• CITY/STATE/ZIP: SUBDIVISION: BLOCK: LOT: ..LOT AREA: /A. ZONE: W -I -DTA: DISTRICT: DEPTH: R/W: * # OF BUILDINGS: # OF DWELLINGS: , WATER DISTRICT: * OWNER: NA+ -y Well /Z;11: -.4-,i &Ad/ aAic5-,J PHONE: SO? - ?2B.,6S % % * * MAILING ADDRESS: / Co 7 N N. Cel 0,Q * * * CITY/STATE/ZIP: cc- �-VAN b -Da— q4 2-( Z * * CONTACT: Desiu PHONE: - q 46 S( * * * SETBACKS: - FRONT: REAR: * * * PERMIT USE: * * ****************************************************************************** * * * LEFT- RIGHT: * BUILDING /4�UA'Y /n INFORMATION `I. CONTRACTOR LICENSE NUMBER: C B c s4e a . /Aqui n J MAILING ADDRESS: 3(0G I4 • /1-OcJNCI CONTRACTOR: ARCHITECT/ENGINEER: MAILING ADDRESS: PHONE: -12e -4Gec PHONE: - - NEW: REMODEL: L ADDITION: DWELL UNITS: OCCUPANT LOAD: CHANGE OF USE: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.: * * REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT: ****************************************************************************** * *