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SPECIAL PERMIT Date . . .. . ... . . ..19 <br /> File, ......... To Building Inspector <br /> Application for Special Permit You are hereby authorized to is <br /> a "Special Permit, for this appl <br /> tion for signature of the Board <br /> Appeals and are hereby advised <br /> this application has received t <br /> ..... approval of the Board of Appeal <br /> Name <br /> If any conditions are written b <br /> ..,.......,t.... .... ........ ..... . .. you are requested to see that t <br /> Location are complied with, and included <br /> permit. <br /> ..t...1........... ............. . .. . . <br /> .... .,�.,..... Ci ) . . ... ... .. <br /> •r......................... ..... .... .... .. . .. ..... <br /> � . .. .. . . .. .. <br /> Permit granted <br /> Yes or No '+ <br /> ..:�... . . . .. . .. ... <br /> Date ................19. ,. <br /> If permit was granted what other . . .. ...... ...... .. . . . . .. . . . . .... <br /> permits were issued by the Building <br /> Department? <br /> To Bu1147 . ..... .. ... . .. .......... .. .. . .. .. . . . . . . . . ... <br /> (1<es or No) (date) ... .. . . ...I.. . . .. . . .. . . .. . . .. <br /> Use & Qccupancy? . . .. .... ... ... .... . . . . . . . . . . . . . �. . <br /> . (Yes or No) (date) Board of Appea. <br /> a <br />