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�' h1IVI\ rvr'�vaTLumLa rLI11V111 <br /> OWNER wtIIIMNt E. QvtCFi s 5'ecn. sea` -U. 0. 3,5 <br /> NME n `! .00nES! '- --TEL NO — <br /> i AMCWMTO LI �f�GRr✓Cr' 13a.f�..t14r1it��'tir� _ __ _ 3�,7/C. - ,'�• '�� <br /> [14600[111 IMI / A �VOnES! TEL N0 - <br /> 1 r77*C k'i✓fy SOATYd Ss a SL4A 9 <br /> CONTRACTOR ApONFS! -- - L NO - - <br /> �• <br /> 1 location of owidinp skeaufrf ral ARLcAgr- KA-OW IS It kV I' <br /> Now.No.M.Sweet SUBONISION C011Ntr . <br /> Aseessm's Information <br /> f'~ MAV SEG. PCL LOT No LOT 50 FOOTAGE <br /> / TYPE OF IMPROVEMENT ( ) Now Construction ( ) Alterollon ( ) Relocation <br /> ( ) <br /> Addition ( ) Change of Occupancy ( 1 Demolition <br /> ' ( ) Mobile Moms ( ) Manufactured Building <br /> SleCL R wcXs Fov Ijoaf Sfo"V'- <br /> t 0n,4+ *(9h yi'cG IS 18� Supervisor's License Ro.4LW?67 <br /> X OaA.FyyA. 1 ' � . <br /> ( PROPOSED USE: ( ) Ptorr•R(eldantlal '' ,IF <br /> ( ) Reslderrtlal No. of Un1ts <br /> ( ) Prhats ( )Public STATE, FEDERAL, TOWN. Etc. / <br /> CONSTRUCTION CNARACTER19TICS: ZONING INFORMATION: r <br /> 1 Zoning District - r <br /> Type of Fromm �• FF/4MLS NOf {�r.m- Nletodul Dlehlel ( ) <br /> Flood Plain Zone ( ) <br /> Type o1 Foundation - Present Non-Conforming Use iX) / V. <br /> Special Permit Required <br /> DIMENSIONS OF BUILDINGS: Variants Required ( ) <br /> Is lot RecordedDwelling <br /> ( ) <br /> Ell's O AL FIRE DEPT. APPROVAL <br /> iTAL REQUIRED ( 1 <br /> Garage -F-FIMT IUW- -msµ <br /> SN Back From Property Unse <br /> Non-Reeldentlal <br /> Other - -�P� - runt - <br /> -Vast . <br /> am saeweara wait H4em 113A r 06 Towne stow oMM outlet„a eetr,ne s Mor.relate far a <br /> Pow* to awlsouct dar,awnaYL elrerl0 M omm"-, of .bumov. f MMM w ow any oqu*,rort owl Is <br /> neJabe <br /> by M Pada aaowpwA\ads eNondes we ale,cook M M 4MLMe/IMn..ne P1.ne.Inefu "PW <br /> pww.The a_i/ ae_eM euMne to tat"Pole ane aPKmewoone er s4a.ea tat buR.M'e MMM any amenM1 ` <br /> wwT4 Or 1e41elarre Tae.a Bai{aa�jaa b.dIw1.A aaY�iN Pir Wn 08 Now to do M Mina WWI$1 baa been <br /> doesney fueao 31 er a Parsee alba ewe been Murat,n <br /> Slgnshxe of Appikarr / l vH P IJ�u Dote — <br /> Additional AppravNs RequlrsAi" <br /> Under Taxn Zoning Lor" arrd jndr Rputsdone of pub(k >isalth Sswege(Tarn of Malhne. <br /> and Comm- if Man.) a Pefwl may(am rte) LV. Isune a:'!-.o.i eumtw Inva•rjetlon. <br /> I 1(4.1�. �_/t� COMMENTS:, <br /> MENTS:, <br /> r LT AGENT <br /> c d0 .9(Z- COMMENTS. 45- t� 1,4.,5 <br /> NSER ION OFFICER TE 1p�� <br /> COMMENTS: 2\ <br /> j <br /> JHELLFISH WARDEN DATIE <br /> ( ) SWXWrsl Pian P4,few Wat"d . p&U Parmfl blued For -•----- <br /> Estimated Cost of Carta>tt4c �— <br /> BUILDING PERMIT No,' <br /> PERMIT FEE D D <br /> r" "'UEO e/ -- APPROVED BY Bul na Commissloner <br />