1981, 04-13 Permit: 81A-2927 Inspect :INSPECTION RECORD
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APPLICANT: COMPLETE NUMBERED SPACES—PRESS HARD TO MAKE 3 COPIES ,
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a'wtS_1 �'1[ 9T LEGAL DESCRIPTION—SEE ATTACHED 0 2e •220,0,
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LOT !LI)fl(.1SU{OIRON PARCEL NUMBER/5 w2ZapcG1
2 4 1 khu..CPLLT Yw2K 17T [u:it-nom '29541-0-D4- •22004.-
OWNER PHONE
a 'DRUID 4 LSAV HEDLEY 97G-G5C6 A Rn9A q g.
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E.12124, z14T ZIP Naos aH n.riaolrta .., 4WN
CONTRACTORPHONE SU.of Parcel i.e. RNINut on -'014'81r,,
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ADDRESS ZIP .mrIan� SnSARKJJOv. Oo U Rem..
DESIGNER PHONE
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5' ADDRESS ZIP 1^°r NP FIe . ...Area storage
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CHANGE OF USE PROM TO ',,Atrea of Deak. elnIM.e Basement Unfln,Elegem*.
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£p44-IIIE, —
�^E ItireEn, ❑ALT. OB AWN. ❑RPL. •0 MVE. 1 N. e.Room I et owes..
7, WORK V'mLD. ❑nLMS. O DECO. O M,H. 0 POOL 0 OTHER CERTIFICATE Bl'd. •a.,a. r.,A.ed. -
et EXEMPTION 4.s
CEICISME WORK team.om. Loudon IAfYI
8j. 'Dial FEES COLLECTED
ALUATION BOUNC{ RM ELECTRIC WATER e�SEWER OwnerMlp VW COOS
UTILITIES A..CPTIG Pumc Cremate 0 115.1 $ , .0.
1 hereto,eertlr Nat J Saes Teed and aeamined this application 11101 have read the NOr I'1 ro Sons included ,g4� *• 1, '
MI reverse side,afld PROW the same to he true and correct All p ovos uns of laws APO I aI cos governing this Build 4/S,E'Q
type of work will be compiled with whether specified herein or not The granting of parr.,does not presume .
to give authority to violate or cel the provisions of any other stare or local law'egolla
q construction or tiro
perftcmetto of eorlatructlon SEE REVERSE SIDE FOR REOUIRED•INSPECTIONS Pluseelna ra
DATE OF oPPLICATI(RNJ+ +,JIU/ SIGNATURE OF uPPLICANT. 1' PergeeiCidefr M.S.IY .j *4'
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,.1jio AMMOyAU 4 1i RIAL CONDITIONSI Plan Check , a.+II'
NAME GATE
PM'ro1M`eeAf/L/fA 3/5/. TEPA dn•,:{
'TIM Memel] Mobilo Hama �u
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lo.[MIIWr Omer(Specify) '. �?A
TOTAL E
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