1980, 08-11 Permit: 80-6731 Inspect/4/_E>L Z
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F.1 1 NUM![R
APPLICATION/PERMIT
NUMBERED SPACES — PRESS
RTMENT
a6&aa)6
3 COPIES
JOSIIIDDRESS
1ON
LOr RLafDis �Deurvhl f[�15'n
z
LEGAL DESCRIPTION — SEE ATTACHED
4.
71o4"06,:2 h,6,r2 A.111Gtt-
7 714.200 s p�aFrJ�
CONO
PHONEG
PARCEL NUMBER/5 07554_ 112
C o1,f X1715 pLfysi)
U Sat Beek, In FM
2-7 !Sown 10 a,tho Iweet
North
Ion} Ia,sRlutlan
ADDRESS
ZIP
Type Conk.
«uPancp
Sprinkle.
Oyes ONo 0 Rue .
D ESIGNER
5. ADDRESS
PHONE
BuilalnlL9Ly hes. FI.
ZIP
CHANGE OP USE PROM
a
TO
TYPE �Ry/
7. OP
wpm,.O SLD, 0 mkt.. M[CN. pp M.H. 0 POOL
0 ALT. 0 A00.1.O RIR-.
0 MVS.
0 OTHER
Main Floor I
Upper Floors q
rap. ArN StoraAree of peak. 1 rimmed Nine Jnlln. Easement
No. Bath. 1 No. stones NO. Rpoma o. *1 Dweillnpa
CERTIFICATE
al EXEMPTION
v1" 1 R. Plnf IIM'!.
D ESCRISE WORN
a E A A Enam, 001. 1 LnNtlp
y1y -MITI
o OURC! OAS ELECTRIC SEWER Ownership ITU!! CODE
8. 1'✓14Q� UT14TIES / IQ kCL ia,GY([C Pupa. op... •(I
I hereby Certify that I have read and examined this application and have read the "NOTICE" provisians included
on reverse side, and know the same to be true and correct. All provisoo, ut laws and indinances governing this
type of work will be complied with whether specified hein o t. The granting of a permit does notpresume
to give authority to violate or cancel the provisions of any other state of local law regulating construction or the
.,,performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS /�/f� ///y �(/
DATE OF APPLICATION y/ fro SIGNATURE OF APPLI CANT C_C""�"� ../a, '
SPECIAL APPROVAL / SPECIAL CONDITIONS:
n IAINI FEES COLLECTED
Env. NNllk NAM[ DATE y.u-r Qc% D� 1/04.111 II .y _ 626.5
ri✓1 I U� 100 — a -60
110n MI
Glae% oG :Mf -r. Kf de'a1
vita- -ro eiv1rJL A
Pee Marshall
Co. Engineer
S' el S
Building
Plumbing
Plain Check
SEPA
Mobil. Homo Co 0
OthM *MINI
TOTAL S OD
PERMIT NUMBER
07* *6000
*6000 0
*60008
*000 8
6730Y
07-07-80
Y 6879.
WHEN MACHINE VALIDATED IN THISSPAC