1984, 07-12 Permit 00001137 MH;IGNATURE OF
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APPLICATION
DATE 7 - cry
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PRITT, DIANNE 1...
Ting 19`0 E: MANSFIELD RD27
1 OKANE ST: WA zIP' 99206-0 0 0 0
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ONTRACTOR:
ADDRESS:
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ADDRESS:
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INSPECTOR:
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M/H PLACEMENT
Site
Number 1 W 14 L 66 H 10
000116E
DATE:
07/12/84
PROJ#:
00001 137
Mobile I'IoMe In :tai.Iatio $50 . 0(
FEES:
Zip
-00000
PAID BY:
PLANS EXAM:
D 0 AT/,E,:
/1 2/1:
TOTAL PEE:::) $50 . 0 0
OFFICE COPY
07 ^12 -84
55195 *50.C,G,�