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<br />.. CITY . DB' ZlIll'SY1UIII.L8 Rma!' APPLI<;:M'I6H <br />JlUII.DOIa IlU~ 1335 .- It, Jephyzbilb, I'L 331142 <br />'13-~'O-~020 nxll13-780-0021 J>>mIi llI:CKIVaP 51 %/0<0 <br /> <br />. . PJQQ Ql;WtN;7 woa ~xmMO ~/3,-CJd.(p....99fe, S . <br />. c;/Ja 5 L.._ - () '.6\Pr ~/3 /10 . fY)cyv/ CIf <br />OWER'S ~ r(; (u..-n ~ I<-t:>J':" PHONE IO~- ~ 7CJ' . WO:tsVN <br />JOB AOOU..I;l..f"1~ --~AilP . <br />LEGAL DESCRIPTION: ~(S) qO . .LOCJC~ 'S~BD~VI8I~~.~ <br />PAAaL 10 t /J, ;'JJ; -:J../-D'3/'/)-- O.OOD6- DCfO 0 ft'lIl1'UV I'Rt'lM PRt'lPIP."'I'Y ",Ax NMT~IP.I <br /> <br />WORK PIlOPSJ:OI dMEW COtIST1'.UC1'ION <br /> <br />o ADDITIOM <br /> <br />CJALURA'rION <br /> <br />o IUIPAIR <br /> <br />o IlI8TALL <br /> <br />o SIGN tJ NOVI 0 DEMOLISa <br />PROPOStIl Ost: OSGI. FAMILY DWELLING OWUL'rIwrlUolILY 0, or ONX'S 0 HOBlLE RONE <br />o ~ERCIAL 0 niDUS'rIlIAL. 0 S~nlMn/G POOL 0 OTHER ,- " <br /> <br />,,'=>nOM O'NOOK ~ '~a;;;v'7.4-hp~. ~ ) <br /> <br /> <br />BOILDING SIZE SQOAU I'OOTAGI HEIGn <br /> <br />UBIDDlTIALI ATTACH (21 PLOT'PLAN. i 121 Ini or aO%LDnlCJ PWI' (1) 81' J:NZI\GY rollHS. <br />aMtUCIAL: ATTACH (3) SErS or '80ILDINQ ,LAN, , (11 .n a1EMY I'ORNS. <br />IF SIGH PERMIT ONLY 1~1 sel. or &NG%WltlED PLANS' REQUIRED. <br />PROPERTY SURVEY alQ01RJ:D lOa ALL >>tw OO>>8'rRDCTION. <br /> <br />PZRNr!rS DQUES'rZD <br /> <br />" <br />AMI' suna <br /> <br />o PZ'oqro.. Energy 0 <br /> <br />H.R.E.C. <br /> <br />V~llA-e <br />:t\ /3/0 7.~B <br /> <br />o aon.OING <br />o tLECTP.ICAL <br />o PLQiBING <br />o HEOIA)/ICAL' ~1A'rIOH dr NJ:ClIANCIAL INSTALlAtION <br />o GU OI\OOFING 0 SPECIALtY 0 O!BtJ. <br /> <br />, <br /> <br />VALUAt'ION or fOUL COH8'tROC'lION <br /> <br />- <br /> <br />rtPE or CONS'tI\OC1'ION: 0 8LOCK <br /> <br />o nwa: <br /> <br />o s'taL <br /> <br />'0 O'1'HEa <br /> <br />rIWISRED FLOOR ILEVArIONS <br /> <br />II . PROJEC! III I'LOOD ZOtlI: MEA Cl <br /> <br />YES 0 NO r <br />. !ere/<. A~6N'I1 CA+ P>.p;o .TIT <br />C€l'teI',S~,-1t ~~.~ <br />l:S:D~L7 ~~ ~ <br /> <br /> <br />IIlnIDD <br /> <br />CJ ~ CONPAllY- Low~s HorYle <br />_0~ ~.IS.~ ~rAn CU.! 01\ Jl.&CiIIT t. C~c.. <br /> <br />..................**....~..*.*........~.................. <br />'.' <br /> <br />SI~roRl: <br /> <br />n.acnuCXA)I <br /> <br />CONPAIIY <br />, <br /> <br />SIGNA TORE <br /> <br />STATI CER! OR REGIlT f <br /> <br />..................**...............**...........................*. <br /> <br />n.tMlU <br /> <br />II GtlA TURI: <br /> <br />CON,AHY' <br />STAt! etat OR REGIS't f <br /> <br />~CAL <br /> <br />................................................................... <br /> <br />S I CAA TORE <br /> <br />CONPlUIY . <br />StAR CEll\' OR REGIS'f I <br /> <br />.*...*....*......~*.....................***..~.!.....*........... <br /> <br />cmIU <br /> <br />COMPANY <br /> <br />SI G)lA TtJRE <br /> <br />r. <br /> <br />8~Arl CEa, O~ ~GI81 t <br />