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<br />eIn .OF ZJ:l'HYlUIII.I.S PDKr!' Al'PL%ClUION <br />8UIIDl1la Z1aPU'fWDl'!' 1335 .- It, 1~11., it. J31142 ~. <br />113-780-0020 nxll13-7'O-0021 5 l b& <br />. ~ DAft UC&1VaD <br />. I1BOHK oc.rtM1' tal ~Im.o <i13. - ~d fo-99~ S <br /> <br />. I <br />'. /" .., fhO'V/ CIf <br />ONWER'S N>>II In, It-or0 '-9ft:vt.0e' ~'. PHON!: fJl62 - 0 'i'h? WCJ.:ts1JN <br />JOa ADDU" . 6 / 51-f / <t'77r. ST <br />LEGAL DESCJUPTIONI ~(S) 1'.....11. aLOCK J'1. 9 'SDBDIVI8ION(i Ty 01 2.. - 1>;, /5 <br />PAaCEl. 10 t ) I ~ 2.b. 2/ -00 JO-J Cfl:!oo - 0080 ,nll'l'a.rv nnw PItnPr.R'PY '!'ax NM'T,.r.\ <br /> <br />WOIK PROPSED, ONEW COtIITll.UC1'ION <br /> <br />a ADDITION <br /> <br />aAL'fERA'l'ION <br /> <br />lJ gPAIR <br /> <br />o nrs'rAlJ, <br /> <br />a SIGN b WOVl a D2HOLI8S ~I ~'.e~-r <br /> <br />PROPOStD on: ~GL rAHILY DWELLING OWUL'1'I-rAHILY Ot or ONI'fS 0 HOBIJJ: RClNI: <br /> <br />OCCMIERCIA1.0niouSTRIAL OS~IMMIWG POOL OO'l'HER <br /> <br />CI RtsTAtllWn . IlEALTH l;llPAR'l'MEN'l' APPROVAL / <br /> <br />...c:annCM 0., WORX ~ Aco 2 W I'Nd6l/~ S . <;;;;?~ / S /' 2..e <br /> <br />80ILDlNG SIZE SOOARK rooTAGE HEIG8'1' <br /> <br />UBIDDI'1'IALI A'fTACH (2) PL01"'LA)l' , (2) IETII or 80ILDnlCJ 'W8 , (1) S1:! lUIERGY rol\HS, <br />CCHlUCIAL: A'1'TACH (3) SETS or 'BOILDINO PLANS, (1) SE' &m:P.GY roRMS. <br />IF SIGH PERHIT ONLY (~) SETS 0., ENGIWEEAED PLANS'REQUIRID. <br />PROPERTY SURVEY lEOOlRED rot ALL NEW OONS'1'ROC'l'ION. <br /> <br />" <br /> <br />o aonDIIlG <br />o tLECTlllCAL <br />o PLOfJlING <br />o HECJWlICAL <br />o G.U OI\OOFING <br /> <br />, <br /> <br />PZRKI!rS REQUESTED <br />VALOAUOM or t.OUL CON8'taOC'fION <br /> <br />" <br />AMP saYle!: <br /> <br />o Proqren Entl'qy 0 <br /> <br />".R.E.C. <br /> <br />~ <br /> <br />VA'l \A-€, <br />7~/,'3~ <br /> <br />o SPECIA1.Tl' <br /> <br />VALUATION or NU:IlANCIAL INSTALLAfION <br />o OTBtll. <br /> <br />- <br /> <br />, <br /> <br />TYPE or CONS1IlOCTION: 0 BLOCK <br />rINISilO rtoO~ ELEVA'1'IONS <br /> <br />o nwo: <br /> <br />o STaL <br /> <br />. 0 O'1'IlEl <br /> <br />IS PROJEcr nr FLOOD ZOtlB AN:AO YEll <br /> <br />0)10 ('" <br />?erep- A~6N "I CA+ p..p;o .ur <br /> <br /> <br />M1IIDU 12 . ~ ~CMPANY. Hotv1-e ,-~~-:t:NA1 <br />SIGHA~ . (f'(l...L{1..J I ,. I . STAn CEllr 01\ REGIlT t. C~c... l S-D ~ l1lf _ 0 <br /> <br />................. ........~...*~.:......a,.................* S2 I ::> <br /> <br />~cv.x <br /> <br />CCMPANY <br />, <br /> <br />SIGNATURE <br /> <br />STATI CERr OR REGIS7 t <br /> <br />....*...........~..*..*.............**...........***.............. <br /> <br />n.tMlD <br /> <br />. I QtlA1'UR& <br /> <br />CON~ANY' <br />8TATE CER'L' OR gGIIT . <br /> <br />~CAl. <br /> <br />. . <br />.................................................................. <br /> <br />COMPANY . <br /> <br />SIGKAfOJU: <br /> <br />srAn: CUT OR REGIS'r . <br /> <br />................*~......................*.*..~.!....**........... <br /> <br />O!'HU <br /> <br />COMPANY <br /> <br />'IGDTOll.! <br /> <br />r. <br /> <br />STATE CE&r Oil IltGI.'1' t <br />