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SPECIAL PERMIT Date ................................ 19...... <br /> File ................................ 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 ' <br /> 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 /> ........................................................t.....:........................ . <br /> j ..............................................................^....................... <br /> ^ Permit granted (....:............... <br /> Yes or No <br /> \ <br /> Date ................................ 19...... <br /> If permit was granted what otlfer permits <br /> were issued by the Building Dept? _ - .................................................................... <br /> CJ To Build? ................fes <br /> ....................................:.......I....................... <br /> (Yes or No) (date) <br /> k l M <br /> ........ . <br /> - Use & occupancy? .................................................. i <br /> o r No) (date) Board of Appeals, <br />