11A-005 (2) 1
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BUILDING 0,
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ry 4,444, - PERMIT a
..... i VALIDATION
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(NO.) (STREET) (CONTR'S LICENSE)
PERMIT TOE"+ J ° NUMBER OF (_) STORY DWELLING UNITS
(TYPE 6F IMPROVEMENT] NO. .(PROPOSED USE)
AT (LOCATION) 1744 a .„r ,F° .R,w..,a ”" 4k DISTR fi 1 I'
DISTRICT t.' T
(NO.) (STREET)
BETWEEN '
(CROSS (CROSS STREET) • (CROSS STREET)
LOT
SUBDIVISION LOT ' BLOCK SIZE
Y
BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
' TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
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AREA OR (10 / d 1 PERMIT 0 0 (I
VOLUME ESTIMATED COST .�` FEE
(CUBIC /50 ARE FEET)
s
• OWNER �^ [
ADDRESS BY ILDI J r r
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WHITE - FILE COPY . GREEN FIELDFCOPY • CANARY - APPLICANT COPY • P -INK - ASSESSORS COPY