1986, 03-27 Permit App: 00010146 AdditionIA]
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DEPARTMENTAL REVIEW
1 certify that 1 have a mined th=Ppoft st hit the information contained in it and submitted
by me or my agent to �o( mpile n is tr coi1'ect.
Date
I
Cond.
Approved Approval
Hold
Environmental Health Application ff
W. 1101 College
Room 29n/•�
Planning/Zoning
N. 721 Jefferson
Engineers
N. 811 Jefferson
Utllities
N. 811 Jefferson
,,*Ian Review/ Fire Prevention
N. 811 Jefferson
i
Ottw(SEPA/Critkal Material/etc.)
Fast Track/Special Inspection Information
Project Representative
Phone
Address
1 certify that 1 have a mined th=Ppoft st hit the information contained in it and submitted
by me or my agent to �o( mpile n is tr coi1'ect.
Date
I