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SPECIAL PLM11 Date . . . .. . . . . . . . .19. . ... <br /> file . . . . .. . . . To Building Inspector <br /> Application for Special Permit You are hereby authorized to issue <br /> a "Special Permit' for this applica- <br /> tion for signature of the Board of <br /> Appeals and are hereby advised that <br /> this application has received the <br /> ,, , " „ . „ , ,, , ,, , approval of the Board of Appeals. <br /> Name <br /> If any conditions are written below <br /> you are requested to see that they <br /> Location are complied with, and included in <br /> permit. <br /> . .. . .. .. . .0 . .. .. . . . . ... ..... .. .. . .. . <br /> Conditions (if any) . . .. .. .. .. . . . . . <br /> dada ... . . ... .... . .. ... . . . . .. . . <br /> . . .. . . .. . . .. .. . . . . . . ..... . . .. . . . . . . <br /> Permit granted ( . . ... .. .. . <br /> ) <br /> Yes or No <br /> . .. .. . . . .. . .. . . . . .. ... . .. . .. . . . . . . . <br /> Date . .. . .. .. .. . .. .. .19.. .. . . .. . <br /> . . .. . . . .. . .. . . . . . . ... . .... . ... . <br /> If permit was granted what other . . . .. . .. .. . . . . . ... .... .... . .. . .. . . . <br /> permits were issued by the Building <br /> Department?. <br /> . . .. . . . . . . . . . . .. . . .. . .. . . . . . . . . . . . . <br /> n To Build? . . .. .. . .. ... . . . ... . .. . .. . <br /> (Yes or No) (date) . . . . . . . .. . . . . . . .. . ... . . .. . . .. . .. . . . <br /> v <br /> aUrV� . . . . . , . . <br /> ' Use & Occupancy? .. " "" " " " '" " " " " ' ' <br /> . (Y . . date . Board of Anpo;,i.S <br /> (Yes or No) (date) <br />