1980, 09-29 Permit: 80B-0575 Inspect1)
INSPECTION RECORD
OWNER
LOCATION
NSEWCONTRACTOR TYPE OF WOR „et,/FINAL INSPECTION: ./AfG�76 f Ate
SET BACKS
DATE REMARKS: .L/ (J/�
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APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES
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LEGAL DESCRIPTION — SEE ATTACHED
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I hereby certify that I NW res ern unmanned this application and n. a n NOimE- included
Oda, ane know the u be e u t o All 01
ype o1Nro,k III be complied w whether Speeilledu em .1 r1 rig a��r, + m
o gin eulnorIty t0 violet cel ,n provisions of ern ulne, U„re a local Ieunlelnl .3 and ecm,suue, not
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Pdlmmpe o;wmWEtlon r ERSE 810E FOR NELVNEL INSPECTIONS �I'I..t• ar"'icnns'u/r OS
CERTIFICATE we.
EXEMETICH
GAS
ELECTRIC
WATER
557055
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