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1987, 05-14 Permit App: 87001346 Remodel z * INFORMATION WORKSHEET * ****************************************************************************** * * * PARCEL NUMBER: 3 L/6 t V- c2%O 3 * * STREET ADDRESS: C /3 / o t /I e s �N y_ * * * CITY/STATE/ZIP: S 01�i,k1 COcz Ct.� / t * * * SUBDIVISION: ti01 -fkivelAA l emoll%lo ri -s g 1- C & ! * * * * BLOCK: LOT: ZONE:_ DISTRICT: * * * LOT AREA: F/A: WIDTH: DEPTH: R/W: * * * # OF BUILDINGS: - # OF DWELLINGS: WATER DISTRICT: * * * OWNER: e ✓vi (4 r) ci t ck w PHONE: 56c/ - F2(7/ - /-S--Z o * * c rr * * MAILING ADDRESS: L-- ( 3/ 0 3 l d 44 (t e S I el * J * * CITY/STATE/ZIP: ZS ,, 1 (a'4- `7c( IL * * * CONTACT: PHONE: - - * * * * SETBACKS: - FRONT: LEFT: RIGHT: REAR: * * t * PERMIT USE: S HIV 21) )( 3 Z * * ****************************************************************************** * 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: I HANDICAP: SEWER (Y/N) : HYDRANT: * ****************************************************************************** gO 41 tt: rnt - fzei, 2eywolt.40_ [-- . pocusorks ! „ ^q- I sri I iAmtS.E. 21 , E- 1 \jv tA-E A-U r