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1988, 03-18 Permit App: 88000541 MH
INFORMATION WORKSHEET 7 3 I 3 _14 3 -0 PARCEL NUMBER: c: i ', STREET ADDRESS: „ V CITY/STATE/ZIP: �( f = !? SUBDIVISION: BLOCK: 2 3 LOT: 3 3 ZONE: DISTRICT: LOT AREA: � F/A: WIDTH: ( -7 -"" DEPTH: R/W: 1(5 * OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: OWNER: I ` / — Vit' 4 ( l ,4/4 �j' t ` PHONE: f — / �� MAILING ADDRESS: CITY/STATE/ZIP: CONTACT: PHONE: — — SETBACKS: — FRONT: LEFT: RIGHT: REAR: PERMIT USE: �� i' -,fi j(/,A7 �' ( ************************** �r**** *** *`************************************** BUILDING INFORMATION CONTRACTOR LICENSE NUMBER: CONTRACTOR: PHONE: — — MAILING ADDRESS: ARCHITECT/ENGINEER: PHONE: — — MAILING ADDRESS: NEW: REMODEL: ADDITION: CHANGE OF USE: DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES: BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. : REQUIRED PARKING: # HANDICAP: SEWER (Y/N) : HYDRANT: V ALL ay V LI 1-1 r)4.57 (17 P't 0.9 I\14 4 c frs - ---ygDyt