611 PINE ST (2).pdfwith the accom.,
APPLICATION is hereby made for a permit to construct the following work in a�cordance
panying plans and specifications. Two sets are submitted herewith for approval.
new alter Off -St'
Workaddn repair .................... .... . ......... ...................................................... Parking ......... . ...........
Occupancy ................................ Const. type ............................... Use zone ...... ew� ........ Fire zone ...................... . ...
Addr. ............. ...... ................ /0 .... A�ot ....................... Blk ........................ Addn .............................. ......
...................................... . ............ . ...
Lot frontage .............. . .................. Area ........ 7.;7..7 .. M� ................ Septic tank.
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Bldg. setbacks front. ......... a1P ... ...... r. side .......... 4 ............... 1. side ....... .............. . rear ...............................
Owner ...... ..... Oel;f .. ........ ....... Address .... V51.1 .. . ... Tel. N-i�?L.7
4,
Builder ............. )45;;ft .. I ........................................ Address. ................. 4-: e L -.02 - �- ............. Tel. No ..............................
................. Tel. No .............................
Plans by ................................................................. Address ..................................
Remarks.................. . .................................................................................................................................................
The above is a correct statement, I and I . agree to comply with all applicable Codes an I d State laws regulating.".:
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work.
.......... . ...........
Signed Owner/Agent.W.01.-��K.�O'?< ....... . ....... . Address ............................................ Date�
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap-
proved plans a opnent nota ns thereon.
,2d specifications, and Building Dep
by ... 4-
Valuation .......... Zro .................... Permit fee ..... w4n.0.0 .............. Recd. ........
Building Department, By ......... ................. Date ....... ................. ...........
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK .................................................... Final, OK ........................................
This Permit does not cover Plumbing, Sewer or Electrical installations.
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. . . . . . . . . . . . . . . . . ... . . . . . . . . .. .
Addresis..a// ..... ............................. Lot ........ ............... Blk ....................... Addn ...........
L....... Area ........................................... Septic tank ......................................................... .
ot frontage ................................
....... ............. r. side ............................. 1. side ............................. rear ............ I ...................
Bldg. setbacka front ......
Owner....'601.... ....... Address. ......... e.,.��
.. ..... ..... ................. Tel. No.
. ...............
Builder .......................................... . ....................... Address. ................................................... Tel.' No ........ .....
................ Tel. NO....' ....
Plans by.. ...... Address .................................... ..... ..........
.........................................................
Remarks......................................................................... . ...................................................... . .......................................
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ent, and I agree to comply with all applicable Codes and State laws regulating
The above is a correct statem
work.
Signed Owner/Agent.�A--.'�dj ... U. Address ........................................... Dam., .......... .......... .
f
PERMIT for the above work is hereby approved, subject to the above coriditions, and to compliance with -the ap,
notations thereon.
proved plans and specifications, and Building Department
. ..........
.6,5:10 ................... Permit fee ...... .................... Recd. by ................. I..
Valuation
Building Department, By .......................... 6rt.:1rr_k .......... ................... Date ..... ...
............................
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK .................................................... Final, OY . .......................................
cover Plumbing, Sewer or Electrical installations.
This Permit does not
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