1979, 11-29 Permit: 79-7947 Inspect T
INSPECTION RECORD
OWNER LOCATION
CONTRACTOR TYPE OF WORK
NSE W FINAL INSPECTION:
SET BACKS
DATE REMARKS: )11‘
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CATION/PERMIT PERMIT NUMBEa
a _ , q NO Els JS ISMtmt r p*alt�N}.WIMNIriesTON IOW I Mil 188481/ DATE ..APPLICANT COMPLETE NUrtaBE RED SPACES—PRESS tlARD TO MAKE 4 COPIES n—
f JOB ADDRESS TM LEGAL DESCRIPTION—SEE ATTACHED -
OT A PARCEL NUMBER/a 2 g3afaf_a9/q
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a AMA
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8
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R4 0 Co Nortn-57' 'south 73 n/54.
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CONTRACTOR PHONE Size or FINN ZemC 1k
4. W NJJCaP.dt _1 ac 04,,E 44.d
,/
ADDRESS Type coon. Occueance Orink..a
o o EO 7 .,0:,,..,].. 99 zee 0.. ❑„. D ReoM.
s
PHONIC ullelne Arm Inge,Pt.
/RR e
6. ZIP Valuation
rim Arm OareNZg 41or.N -
acoal18 CLf(0, r/Ji
cnanel or Oil PROM ITO gain lntrr pit L•aII
No.j,h. I vPNa. ar i No. ma m_Room
E In NEW ❑ALT. A ACM ❑RPL, I]MVM. OTHER
), OF
LJ woaa O eco. 0 PLMB. ❑MECH. 0 M.H. 0 POOL CERTIFICATE R..'4. Rud. rat Ree d
of EXEMPTION
///o;;;ca�nplpe oRH �1/1N�-
PM CWLFCTfO
8 rte, yq i d'0OAS �4�a I I WATER I SEWER
doe'-/3100: uvuu.. sins. t _
I hereby certify that I have reed and examined this application and hive read the"NOTICE”provulona MERINOon pp11(%3.
averse side,and know the same'a be true and correct.All provisions
of rem and ordinances governing this gum. 46,�
none of work will ho complied with whether specified herein or not.The granting of a permit does not presume
Ir,n.,r arr..,rr ,."law or camel tllu olov mons of any other state or local law rega��lyytins cOnetruCtiOn or the Plumbing
41
DATE//—/.?-_7_9"____.
rr7_ .. _ SIGNA Ions //-///'L.. Mech.
SPECIAL APPROVALS SPECIAL CONDITIONS: Plan CRNk
eT. REq'D. REc o.
o7_1-to iir- //—/3-79 0K EepA
A•nnme Mobil.Nome
P im Meneell
L e Cra , OINK iR.elfyl
O
TOTAL $
Zone CH•r•nc• rig e
WHEN MACHINE MAL'DATED IN T/ '.arrI
SEPann.rolbt pLAesS OK THIS BECOMES 0 PE Reals/) r�
nATF 11-14-7`4 ocFICIAL riim,A_. '� r I
4.