1980, 02-05 Permit: 80-801 Inspect'I►
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INSPECTION RECORD
LOCATION
OWNER
TYPE OF WORK
CONTRACTOR _______
N S E W FINAL INSPECTION:
SET BACKS
DATE REMARKS:
�o 0 e a
/- ed a d i
4i4d coo WOCrilie
140 GWeeir a, + r ' _1
8 —
. --
. . ,.......o.....—,r----.........- •
IP
. .
__. .. .
rr.,....r_ juminimium. im PERMIT
Fj/7?eY..
. -- • ,N,‘..F9
PPLICANT: COMPLETE NUMBERED SPACES—PRESS HARD TO MAKE 4 COPIES DATE
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1.
• *164.00 ' _
LEGAL DESCRIPTION-SEE ATTACHED 02*
l Lk. iLULK SLUIVIMUN I PARCEL NUMBERM .245+I 13°94 .16400
, 2 Orlelgitidi-CY .164002
ly,0 oy, nic. ,..,.. 4 mc.
OWNER A 0 PHONE
A0113(11ESS`'" 114°1411e;. . E *000 8
ZIP
1 4 l9 2
L..
CONTRACTOR PHONE 2 1SIFe of Parcel 0 1-21.1-80.5aLetao-1 2- tio-r-rsr .._7x 5,00 Zo;41•ss118elliri Jo 6479
ZIP TVIlle Const. OccupenFT SATInilered
1,10r VI*Vc arts, Ono DR,**.
DESIGNER PHONE ValuatIon PT+ 0 0 0 Bulialrqzin SQ.Ft.
-
5. ADDRESS ZIP 1, Aerlfie_ Basement Area Garage ArTs- Stowe
I CHANGE OF USE FROM ITO Split Entry S011t Leval Rancher
6.
No.Baths No.Floors No.Rooms Rec.Room
r if w 0 ALT. ErAO'N. 0 RPL. 0 mvE.
L MECH OTHER
PLME0 • 0 M.H. 0 POOL
CERTIFICATE 1.2.F., OeF'd• rot Rea',
I of EXEMPTION
j
I i. c-)GrAm'a, -o t",*-
-r, KK- lorriog FEES COLLECTED
I VALUATI N Sou;ce GAS ELECTRIC WATER SEWER p
9. .P-41-,(2 oc::, Ilt4es
I Single s -
I hereby col lily that I have read dn.!iitiounrieri this applicatiou dlid FIJI,le•Id OW-NO I I,I-ii,ov,uort,Incirirlarl
on reverse sule,ally know the saiiiii to tie nue aurt i.frrierit.All 1,11111O111,of lows dorl ii•iira es oovetiuriy triu 80110109 I +
of work will be coroollefl 10,wile110,1 st1e1oI,III 111,10111 or 1101 I ho 1110111111 iii,Pi,,iiii 1,0011101 PreSlllnl•
vo authority to violate or ituir,a1 thri iti curium,ul tiny olliei iirrie oi local la,,iiiihlaiii i unstruction oi ihri ,m,,,,,
-
iiihu
ii rIlae II I'Of COnStrUCtiOn.
L••••11 I--;-'1.••SCO-.---- ,IGNAIU1117,n•••••.ALC.0 LL. • eg-I.1 Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS:
DEPT, RELI.O. REVD. e.,:otekAacrlio F., INDIA, t41/%11,, 1'4 :leo Cheek
/
Env.Holtl, pLArio. + I/IC, 5
SERA
Plennine , ,...
-
Pim Marsha. MAI I... lb C•Ottril-I9r2. Mobile Home
Co.Engineer Other ISpeolvl ill iliji/
uolities
TOTAL 8 164"
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