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BROADWAY & PARK DONREY OUTDOOR ADVERTISING - BILLBOARD
(THIS IS NOT A PERMIT) BUILDING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND COMPLETE IN INK - (Please return this original and your building plans to the Department ot Building and Sa(ety) SHADED AREAS ARE FOR OEPARTMENTAL USE ~ ProJect Number OMC r's Name L T FIRST MI Proj Addreys (St( Name 4 Number) ZiA ~ ~~f A icanf Address on(w CitY State ~ Zip qci 7D-Z Phone ~.~9 ~ ~ ~ cl - 8usiness PhOne ( 1 ractorlAgent y AdcIrESs G~C~(~~C1~, CitY ~ ~ St~ t~~ ~ J 'cP Phone ~ ~~l i ~ ~ ~ Zo Z (561) (~or taCt I-) Ucen;c VumUer (i',cquired) Busine55 Phonc 1Ct n 11 t?) l E.C LNZ2)-oO,-~ (L5' chitect / Engineer Address E- - I G I ~ GJ a Ac, City J State ZiD Phon? ---T Li-LO CoM Business Phone L~/.~~17~~~~- t~091 499- '17/&gT Lender ~ Acidress aty Siate Li p phone l 1 i!(sonif ibe Wo! ~l.'o~ ! , ~1~~ ~ . . • Res. Comm. .5~,1 bdiriPla Ndme/Short Plat Number (f -''s~ z,';;;,•;. , k0n Assa3sor Paresl Number Lot 8tock Plat Number . I 1* I~ P'Affln@JltFile b6fs L'Or18 , . Comp, Plan ( C',e,nsus i r,, ~.ct e-.-~ - ~ Numbes of Dweliing Umts Number of 6uiidings L~t Size (Sq. Ft.lAcr2) Ccrpth froniarya r +~YS'-oti3y-'bi.c"'~ i.~si;'~1.~:-v: * - . . ! ~ . . • FtOntSet 1beck'r,;'i-, Left SetDack Right Setback Fiear Setback R/W Width Addi t lonal I n format ion Square Footaga . - Z O . ~ ~ . . ' • . • , . . • . _ • . . Q . . . {~~'~y/,!,,^~yr, - i ' . _ • . . • ~ . •,,-C: t -•{{~rfi ~+~~!R.l:'• ~ 'V• . • ''1 • ' ~ ~ • • ' • ~ ' • ~ . l.t, s/.~ ~ . , ~ . ' ' 1 • . ' . . • . . • . ~ , ~ ' : ' . . . • , ~ - , , ~ , ' , , . ~";~.~'~4~'~`~~~~ .Y.•1il•~• • , . ..`S . • . . • r•.. • ' . • . . ~O- ' , . ' . • ~l~ \•~,i'°`~~`~. . . • , ~ . • • . , ' , • ' , ~ : • • . ,e , . . ~ ~ Z , •r . • • , : . • . V Z Qy,~;~#~~*,~"s •°,s~''~'''°. . • - p -k _ ~ . , • . ' ~ ' ~ . ' . ~ , • ' . . : . . . ~ ~ ~ ~ . . , • • m, Nuinberal BcxiroorAS 'T•~ .+•~i+'q.i•;i.,' . ' - ; , , ~ . • . ' . • ~ • • . ' ' • . . . . . ' ' . . . . ,Y: b'~• •ZiS+~P~'~ ~~•Nf•~~{i:t w~. ~i~•, t~ . _ . . , • • . • , ~ 4 . . . _ : i . ..-J . . :.y. • . l 1 . ' ~ ~r . . . c8ulldlnaTechnkfan. . . . Oate • . ~ . . ~ . . . - , ; • . , . . . . . ' • • . - ~ • . . ' y. ' ~ • , . • • , Group' , Type , . .:"~ii' ~ ~~'~`I' • 'wrt^~~. . _ , ~ ~ ~ , - ~ . • : : • . . . . . , . , • . , , . , : . • 4J ~ { ! # . . ' ~ ~ ~ f ~ . . _ ~ + - - • _ ~ _ . ; . I _ • ' - - - - - ! . . _ ' _ i _ ~ ~ - i ~ . . ' I : . ' . . : . . • ~ - ~ - ! . ~ # . i ~ . _ . # ~ . ~ . f ~ . - ~ - - ~ • ' - - ~ • - ~ - : - ' • ~ - ~ _ ~ : , ` j- t ~ ~ r. .i ~ .t-- r• : j_. i . . ; . . . . ` . _ . . _ ; . . : . . . ~ . . _ . _.i . . • . . i . : . . ' , . ~ . + ~ . ; i . . . ~ . , p . . . _ ~ j , i ' ~ ~ ' ~ ' ~ ~ ' ' : i • ; ` - i _ . _ _ ' i . . _ , . ~ _ - ~ -i• .i ; - • - _ _ . . _ ~ • • - - • e - - _ : i f , • ~ f . , , ; . . . . . ; r--- • ~ . . . . . ! ` . . Iz: . ~ . , 1 . , ~ ~ J 1 - ` • ~ ' . ' ' ' ' - - f • ~ - ~ ~ ; , - . • , ~ _ , ~ ; t_ f : 07 r " : .o . . : ; • ~ -1 - ~ - - : . _ . _ • ►Z ~ t . 1 ._i_ ~~c~1 ~ _i_ ~ . ~ _ ~ . ~ ~ ~ 3 ~ ~ + • j 1~ ~ .-t- ~ ' ~ • ! - ~ ! ' ' ~ . ! ; ~ , • ~ i~ ~ . • ~ ~ - ~ - • ' - - f ; ~ _ . _ ( , ~ ' e ~ ~ • , ~ t ' 1 . ~ . 4 . . r _ _ y f _ , _ , ~ -1 ; • : . 1 ? . ; ~ : _ , . ; ;r 4 ~ . ! . ~ ; ~ . . . . . : ' . . ~ _ . . . _ . ~ • _ j . --f• - ~ . ...f . . . _ : 1 _ . ; _ . _ . . . I . . ~ . : _ ' ~ , ._._.._.~._._-.t ~ I I ! ~ ~ • ' ~ ~ ' ` ' ' : . + . . . . . - ' i - ' ; ` . ~ . . . _ . . . . _ ~ _ i _ _ _ . ~ ' . [ ~ . j 4 I ~ 1 ~ ' i f 1 { ' ~ i ~ ` ~ ~ . _ . _ ~ . . ~ . . . _ ~ . _ ! - _ _ - • - - - - - - . . _ ' ~ 1- - - • f-- ty _ ~ ~ i i - ~ ~ - ~ ` ' - • ~ ' - . ~ ' ! - : r ~ ~ ~ . . _ ; . _ ; - - . ; ~ ~ - - ~ - - = - - # _ . : ; ~ a F;* DEPARTNlENTRL RE1JIE1N , . . Cand. ~ ' AFProved ApPrvval Hold . _ 1 ' Envlronmen#aI Health Applicatior~ # El 1N. i1oi t:oIfege ' Anam 200 ' . I ' . ~ ~ PlannInglZoning .s~•`~~~~ - f = ~f ~ ❑ N. 721 Jefferson 0/ qw, 0" , r~ ~ L' ~.r~t.i~ ' _ .~.1~• 40 ~ - e . . • . . Englneera - E3 N. 811 Jefferson _ 41 Ut6liiEe~ El N. 811 Jefferson ~ Plan ReviewJFire Preventlon ~ N. 8'11 Jef #erson . . „ O#her(SEFAfC rltfcal Materialfetc.) n ~ fasl TracklSpeciii! inapecfion artformatlon ~ - PraJact Representative ' Phone Adtl r8ss ! certsfy that I have exarnined this appllcation and state that the `nforma#ion coniained irw it artd submi;ted • by me or rny agent ia earnpile said applicativn is xrue and correck. Signa#ure ~ Date