1981, 12-16 Permit: 81A-2152 Inspect •
INSPECTION RECORD 4
ADDRESS
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NORTH + $ '`I sed•A 'Na'I'ON mew/10001 sSeabve (L, // .
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APPLICANT: COMPLETE NUMBERED SPACES-PRESS PARD TO MAKE 3 COPIES `
JOE ADDRESS�+ p_g �,/ 02• A500, _
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lolila IL ILO I 6 fgroN' LEGAL DESCRIPTION-SEE ATTACHED .50 C G
,t PARCEL •
NUMMI/5�V-.4L,i_KJ'!-,
2 L1 T oft,'(4.44.t•e-..." L+1 raZ- %./,'.• /?,LX H e 50 C CIS
a ti .r� 'R1,.fA Six- /G�4 /7 9-n'G-lsL,B `Kyv o vARES/c ALL. ,oCo E
noon a- ZIP Actual S.e .In Pact 1 g 2 8 Y
Er/4d/� ,.,.v2 ,d�Ct-�,4A4.L.. q R%-0L Nom,LG.Racks
39v lest z'1`r Iwe:k v 03=02 E1
EONT.170 �. r „cyi
1. FlJ 92/f'69�3 5o 14.a.r/cc0 common. ZeLfu,..J. a<-.. � Y 6479
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5. oNE PHONE �44.73.,=f,----Ion Agt gI fie' SO.Fl
ADDRESS -.ZIP /r U er Floorr O.r.ge ANe Sleraq.
CHANGE Of USE FROM ITD Area or Deca. Ficivv2e easement I dn.,cae.m.nt
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TyKo_Ra xa e.Stories I Ne R m. He.et Dwollnp \
7. T. Cl,0 NEW 0 ALT. 12/AEVN. 0 RPL ❑MVS. OTHER N/ 11 1 ee I •
WORK-MELD. Cl P1.ME. Cl MECH. ❑M.N. ❑POOL CERTIFICATE nee,. nee,. rveinw4.
i EECRv E WORK el EXEMPTION
�f N Cnum.DiR. Location IA(MI
fl Qd AT UNCE 1'ff OAS LEL rC I TER" 000 No USE PEES COLLECTED (`..
/J I I T I SEWER CODE
T• Si��d TIL+TIE6 Ic•O Prnan gin la $ .1
ding
la hereby velhty that I have read and examined This.A111.10011 011 and have bead the"NU IICt otiw1,1,ms included
side,end know the same to be true and correct.All Uluvesmbbx of law.IMO I.i,,,.nii er unuerulug this Eelldl �5r,
reverseon
type of work will be Complied with whndleb 401cll10d horein,JI no rho gran tiny nl b no,ti , .,, m`presume
to give authority to violate or cancel the ploy of any Other state or local aYpsii b itinii�'.,„b•:n vet on or the
Performance of construction,SEE REVERSE SIDE FOR REQUIRED INSPECTIO Plumbing
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DATE OF APPLICATION 3"e2QIU
.- 1 SNAIUNL IIr API'I.I(:AN1 Mach
EHCIAL APPROVAL! SPECIAL CONDITIONS:
NOW DATE c P-0-
PF ____S/it_ SEPA
en a ---- MobileMgme
,mno•. om.r lep«Iryl
•• TOTAL $ ASG
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