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1985, 09-20 Permit: 00007575 Wood Stove
SIGNATURE OF APPLICATION OWNER OR AGENT DATE JOB ADDRESS: SEQ. 5: DATE: PROJ*: 4?tl (85-t-v.4 AV g7�` dGl�c7/�3" OWNER: CJ kEiz.�a ryr , c�t1N ADDRESS: 4-1( I T CITY: ST: ZIP: 5--p ItAN , iti IA rtei2-0G APPLICANT: CONTRACTOR: ADDRESS: CITY: ST: ZIP: PH: LICENSE*: ARCH/ENGINEER: ADDRESS: CITY: ST: ZIP: PARCEL*: CENSUS TR: INSPECTOR: z7- 5 3Z-Q1 0 PLAT*: LOT&BLOCK FINAL PLAT NAME: ZONE*: ZONE FSB 5-1 S-2 RSB MOD A6 al USE OF PERMIT: FEES: PAID BY: CA CK CG NC Vi COD 20.0G� JOB ADDRESS: COONsP PLANS EXAM: DATE: 4-itlC . ST" ►Nv. } a 0 0 W 0 LL LL 0 QCli;2C3/�'j`5 5(58 Za.(9