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COiVl'ACT PEI�SON <br /> �OR PERNIIT APPLICATIOIV <br /> THE CONTi4C1" PERSOIV WIL� �E CO1VT"AC7'E� FOP� CORRECT70NS, EP�ROf2S, <br /> ADDITIONAL INFORMATION, ETC. <br /> FBC 104.1.6 TIME LIMITATIO(VS: AN APPLICATION FOR A PERMIT FOR ANY <br /> PROPOSED WORK SHALL BE DEEMED TO HAVE BEEN ABANDONED SIX MONTHS <br /> AFTER THE DATE OF FILING FOR THE PERMIT, UNLESS A PERMIT r-IAS BEEN ISSUED <br /> WITHIN THE SIX-MONTH DATE. <br /> DATE: ��aZp�/� <br /> CONTRACTOR NAME: J J� cS D/1/ ��I.�yyl�/�/� <br /> COMPANY: N�GJ Y)')�/�IV��D� ��� <br /> PHOIVE. �)3� ��o?� 9f��� <br /> CELL PHONE: <br /> E-MAIL ADDRESS: �e W l n �jbtJ l.�L{»e�/,�1G�ny>���'�ry�jDJ'l, COm <br /> FAX: 35 0"�?- LP1P � ' ��D,3 <br /> PERMIT SERVICE NAME: ��,'�j �?V�� U�I�j �po�/n/� 2'l��y� <br /> PERMIT SERVICE PHONE: �13- �Zv a?- �J'`�� � <br /> NOTES: <br /> ta/public/bcs/bcs forms/permitverificatio.�_2011-05-17 Page 2 of 2 <br />