23A-286 (31) Z DEPT. FILE COPY
D
CITY OF NORTNAWTON p� BUILDING fa
NORTHAD'BTONr MOS. 23A _ 286 PERMIT VALIDA71ON
DATE December 30. IR 77 PERMIT NO, 597
APPLICANT r .} TnE — ADDRESS A�tf"B St.r Northa®ten
(NO.) IS Tp FE TI I...T R'9 LICENSE)
PERMIT TO T4Ye{nmmm lAAi fi nll ( �) OF
BTOflY OWELLRING UNITS
(TYPE v EMExiI IPeOPOEEo E"
ZONING
AT (LOCATION) �TAb &k QfnRrtt'3 P9 fYTenPmE Mmnd DIBTR ICT "T
(xa.l ISTREEiI
BETWEEN AND
(CROSS STREET) (CROSS b AI
m SUBDIVISION LOT
LOT_BLOCK SIZE
p BUILDING IS TO BE 23-FT, WIDE BY 2F; FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
O
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
F ITY PEI
REMARKS: Add{t{EST tp TIIdlletrl87. $LdQ.
AREA OR (CUBIC/SQUARE FEET) ESTIMATED PERMIT
VOLUME ESTIMATED COST p FEE
OWNER Peretan U.S. euumN o 1
ADDRESS Hanotun4 StZmet. Llort3amoton Maa Br
(Affidavit on reverse side of application To be completed by authorized agent of owner)
I hereby certify that the proposed work is authorized by the owner of record
and 1 have been authorized by the owner to make: this application as. ♦lis, ..
authorized agent.
SIGNATURE OF `AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19_.
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