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a1�7So Cii �afi Zeptiyrtiilii fti lit AppkatiO, <br /> -.Date Received' '>Phone Corrtaetfbr �J <br /> G. R�Tme owi>�'Phono <br /> orn�slmm, . - J7 � �.�,t ownerPltonet�ar <br /> owrters_A4r4SG,> .� a� P21 <br /> Fee Sfmpte',[ftleholderlleme Owner PIIOn!Illnfeher <br /> Fie SUB # <br /> t (J` <br /> .t06 ADDRESS <br /> SU4 <br /> �, PARCELI6! <br /> ioM-- . D <br /> - <br /> - - =- - - - (OBTA�!®FRONIROIHRYTA7Ili07lCE) --} <br /> WORK PROPOSED NEW WFBTR�- AQDIALT Q SIGN i w�- Q DEMOLISH r <br /> INSTALL REPAIR <br /> 1 ; e - <br /> PDE.. c� sFR <br /> TYPE OF s BLIXMC- <br /> _ - _ '. .._ <br /> BWLDIItGSI�, SQFOOTA6E� HEIGFtf',' ,�: <br /> BBUILD IN <br /> _ - VAI:W►`iTON'OF•7pTAL`CONSTRU6`fi - <br /> C-(FCTRtCAL_ _ S,, •, •=' - ;.Q':. PROGRESS_F.NERGY'"- VILR:E:C:,::.., <br /> - , <br /> •���(��CA VALUAT{ON OFN�CHANICAL-WSTA4ATIOM, <br /> QCd►S �' ROOFING. 0.:' _SPECIAITY;�" OTH _ <br /> OOR ELEVATIONS., ss:F000Q ZONE!(REA YES- NO, <br /> - <br /> SUp,ppz.' <br /> SW*TUR'e fir;':: Y1-:N" TEk,cu`� :�, :Y-PN:. . <br /> I <br /> rise <br /> :i y:K <br /> Y <br /> SILiliATURE REorEn®`' 'YPNcurazII YIN <br /> l77 <br /> SlQNATURE t c�SmiEo:::- Y/N'. V`',FEEQJJ RE <br /> Fiddles z .- u, <br /> S"AIURE'r `_ REGI$►ERm;_-:.;' :Y/= =.:FEEcu <br /> JI,__ <br /> its _ afn .,Ye.. -?- p1 [ t.a .,'s;,i".,.',' Al <br /> NYl <br /> SIGNATURE, _ REo�srERM .Y!'N FeEcu Y I N <br /> Addtess ; = License# <br /> r1'a'17 1 <br /> RESIDEMfAL ptmdl(2)Pit P%ms(2)c�ts.of Buildnti�'lana:(1)set dEnetpy Fans R O W,Pemut for'tiewiuoti:; <br /> wribli ni terl."(10)worldnB d�rs aReF'sitlxi tai date.,.Requaed onsde.Coro W on 1?lara:Startmvafect?ianS wl SllFence msta7lad _ <br /> Sanfiniy Fac3litloe'E.1 dmnpcfd�:Sma Wadr"Ponriit.tfor�Pholacts - - -- - -'--' , <br /> OOMMERCMt.': Atd'J�(2j'caiipt�to d Buii�np Plans plies i Lifa,Safaty?ape:(1)set d Enow Fb—R-0-W PertNt for new rmb n_ - <br /> Albinuart t�i(10)wwpny days eRarsutanllmi data Re9Wlad otism.Coristlrctiorl Plans S�ortmvaler Plans w!Sdt Fence ulsiai' -` <br /> }:, ' SalrtarY Fac tles d'1 dulryaotr Site Watk Pemrt farad)new .AD commeiaa! must fhw comptiat <br /> SIGFI PERIAIT Aftadi(2).sils o.Ec�erad Rl- F, <br /> ""PROPERT1f,StAtVEY i®4!+l ed fora9 NEW :-` ; <br /> FM call-(malpleW- <br /> Own&a Coil4edcr <br /> - _tf over,i2500:a NOflw,of,'t�l�lt- _ is`iaqut�Lr(AIC.uP�S om�r i7500). - - - - - <br /> Agent(forihe ) Ram d'Attomey(farihe owner)would be sornacile with natelhed letter from oxmer autttarmr0'same-= <br /> OYERTHE'CouNTFdtPFRiliiTpll3._ (coPYdaontradrequrted) <br /> Reroafs,if shirigtes. Sewers S Up9lsides,A!C :fences(F'IarJS!aveylFoolaBej <br /> Dr(wwws Not over Counter if on pub( rbad4vaf s.:lreeds ROW <br />