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SPECIAL PERMIT Date ................................ 19...... <br /> File ................................ <br /> To Building Inspector: <br /> You are hereby authorized to issue a <br /> APPLICATION for SPECIAL PERMIT "Special Permit" for this application for <br /> signature of the Board of Appeals and are <br /> hereby advised that this application has <br /> received the approval -of the Board of <br /> Appeals. <br /> ............................................................................:...... <br /> Name If any conditions are written below, you <br /> are requested to see that they are complied <br /> with, and included in permit. <br /> ..................................................................................... <br /> Location <br /> Conditions (if any) ...................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> .................................................................... ............ . <br /> ........................................................................ .............. <br /> Permit granted (....................) <br /> Yes or No s <br /> Date ................................ 19...... ............................................................... <br /> ••t` t�• If permit was granted what other permits <br /> i were issued by the Building Dept? <br /> �. AZ <br /> To Build? <br /> (Yes or No) (date) .....................................:............ <br /> and of Appeals <br />