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SPECIAL PERMIT 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¢hefeby advised tha <br /> this applicatio as reegived ;the <br /> , ,, , , , , , , ,, , , , . . .. .. . . . . . . . .. . . . . approval of th and o5 Appeals. <br /> Name <br /> If any conditio are writVr4below <br /> you are requested ao see that they <br /> Location are complied with, and included i44 <br /> �* <br /> permit. I } <br /> . . . . . . . . . . . . . . . . . . . . ... .. . .. . . . . . . . . <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . <br /> Conditions (if any) . . . . . . . . . . . . . . . <br /> Permit granted ( . . . . . . . . . . <br /> ) <br /> Yes or No <br /> Date .. . . . . . . . . . . .. . .19. . . . <br /> Ifpermit was granted what other . . . . . . . . . . . . . . . . . . ... . . . . . . . . . • • • • • <br /> permits were issued by the Building <br /> Department?. . . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> To Build? . . . . . . . . . . . .. .. . . .. . . .. <br /> (Yes or No) (date) . . . . . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . . <br /> Use & Occupancy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> (Yes or No)�(date) Board of Appeals <br /> r <br />