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o SPECIAL PERMIT Date . .I . .19. . <br /> as Of File .. ... . . . . To Building Inspector <br /> � � h <br /> You are hereby authorized to issue <br /> y Application for Special Permit a "Special Permit1 for this applica- <br /> tion for signature of the Board of <br /> C Appeals and are hereby advised that <br /> this r <br /> + ived the <br /> • . . . .. .. . . .. . .. . .. .. . . . .. .. . . . . . . . . approval ofathe nBoard has rofeAppeals. <br /> Name I <br /> If any conditions are written below, <br /> „ • you are requested to see that they <br /> 3 3 V) \ Location are complied with, and included in <br /> permit. <br /> 3 .. . . .. .. .. . . .. .. . .. . .. .. .. .. .. . . . .. . <br /> �9 3 <br /> . . .. .. .. .. .. . .. . . . . . . . . . . . . . . . . . . . . . Conditions (if any) . .. . .. . . <br /> n . <br /> . .... ..... . .. . . .. . . .. . .. . . . . . . .. . . . <br /> ... . . . . . .. . .. .. .. . . ... . .. . . .. . . .. . <br /> D . . .. . . . .. . .. . . .. . .. ... .. .. . . . . . . . . . <br /> J X <br /> Permit granted ( . .. .. . .. . . <br /> ) <br /> 3 t Yes or No <br /> a , Date .. .. .. . . . . . .. .. .19. .. . <br /> \ . . .. .. ... . .. . . . . .. . . .. .... . . . . . . . . . <br /> je . . . . . . . .. . . . . . . . . . .. . .. .. . . . . . . . .. . <br /> � If permit was granted what other . . .. . . .. .. . . . . . . . . . . . . .... .. . . .. . . . <br /> i <br /> permits were issued by the Building <br /> Department? <br /> - . . . . . .. . . . .. . . . . . . .. . . . . . .. .. . . . . .. . . . . . . . . <br /> o � � ��"; To Build? . . . .. . .. .. . . ..(Yes or No) (date) <br /> g � � r <br /> Use & Occupancy? . . . . . . . . Bd f Appeals. . <br /> oaro <br /> . (Yes or No) (date) <br /> r <br /> � C u <br /> 1 <br /> y T S <br />