Loading...
115 5th Ave S_6pgs__Redactedn.-�^t..".w, .. .l, ....'.",°i.riM:�*r•�7;q "t+.r r,/:p. wy�. rrr xr•. 4iT-..� vp+r�Dwi - on.r _ _ , ,. C 1'H r �'u .. .1 ..,.'.p7.."R!'7a ;fA^r wr*'rn. +,•sue VT',� .y Yf`!'*v'�jry""'+t'r�""'.7�p,�`y+!''^"".^"sm, ssf.,vp-,y..,.�y .. �Dv 1, 1 _ {I.`y'�? VIOITVI3V3A9 3A1� �; I II TA093A VIOIT0392"I b8 2 9vA N�i�t's9M ZSAS� Uw ,t,,Mums )a r3,na �stiv�92 . '�' a• 00 HalfAOHOM 8aMOM03� . fl31fl8 ❑ $�S$Q AW ��39�9V� 99CJ"1't9� 9�g51SilSOM HHN 30ARF13T 3HAJTWubm ❑ D�S�-�ZZ <Z SQ� 9stOsLg �` "r 03TAfl09fl00VlIV1U ❑ T HTRIG T91H2�Npff8 YON IJf,}��9 OS08e 2 sunsvA dt a at P `` :NOITAOOJ ysm 03JU03HO8 08r� e :3VlOH9 asi:hsgo19 yisbnssJ :3MAVl223V112U8 4 3U0 3TA0 EMIR 4 FIRU OS08e AW ,abnomb3 ,2 sun9vA d1a at P DOUTAM :223flOOA ow TM3RHU0 YTIO E�-- 223MIOU8 30H30IJ 3TA0 NOIT0392NI JAITIMI f-1 -. y 5• - i-i :3MOH9 3MOH :fl30WO 883WIPU8 44eaaT88s4 AiN ,anivelS u :3MOH9 3MOH : r YO03OF13M3 :3MOH9 3MOH ) :S-22300A Y3A 1%N4ij `r+p Zn,10 :JIAM3' r i _]i 1 •i :03TOATN00 MOOR39 :FIOT0392V1190 3MAM 09 �i1i TI' s Ti -QM3TZY2 MOIT143V3Rq 3RR TF]og3R 1401T03ga"l eow6mo3� R31R8 ❑ 30AFIR3T 311AJTMUOM ❑ a3TAR09ROONIMU ❑ �•`:`';�T91H2 S NOITAT2 2 svA svAiba�sM ZS�Si 80S8Q AWN 33s�sv� OOSi-iZZ �ZS�� snos�q S�Si-iZZ <ZS�� xa'� 03JU173H32 08P8P`VCS 4 3UO 3TAO � / FlI9U CoS tR TA3SRU3 ON 83Y YTIO j� 883141OU8 u, 321433IJ 3TAO NOIT3392NI JAITINI a\-Z�\-S�\ :3NOH9 :30OH9 3MOH bna zb�om�� ;rssya �sviv�s2 9�A'('i9T 9�aliSiuOM :3NOH9 3MOH A�eBa�$CSA :30OH9 3MOH 'Nei 03 o 1� �'tO.i1�3>i32SQ9'iI� WWW :NOITAOOJ os08e 2 sunsvA rif 8 8 r r - :3MAN 283012U8 asi:hegolq yisbngpeJ ONIJIAM :223ROOA , OS08C 'AW ,2bnomb3 ,8 sunsvA riff 8 t P :R3NWO 223MU8 :rY3W30R3M3 AiiA ,onivs18 :S-88333A Y3N Zn 1y)I l Al �A :JIAM3 :03TOATN03 NO2R39 :ROT3392NI 90 3MAN r; T 33 :2M3T8Y8 3Fi13 2NOITA3INUMMoo \ 2NOITA30 eoMo s ftz%3n..__...s="W E 2 a c � 8YAa OE TX3W 3HT MI (2)VIOITAJOIV 3VO8A 3HT T03FIAbo OT 338oA I 200ITAJOIV NOIT33920I-38 JANI9 No12N3 NOIT3392NI-3A bnS NOIT3392NI-3R tzt :03TIO :3UO 3TAO :OT 03TNAfia :3UO 3TAO 3UO 3TAO NO2f139 :03TOATMOO :FOT3392NI 002R39 :03T3ATHOO :FIOT0392N1 r ..�. NO2R39 :03TOATNOO S :fiOT0392111 E :3TAO :3TAO :3TAO 03U221 NOITATIO NOITATIO-3fi9 :;^ ` 2NOITAJOIV 2NOITAJOIV a :R38MUN T1438 R3TT3J d r z r 1 3000 :001TO38 :3TAO a S a S g T91333A NAUT3A E i L 03VI333A C E C :101T1209210 � :3TAG a A 81 A g - ON ❑ 23Y ❑ 03033H R3TT3J ON ❑ 23Y 0 03m R3TT3J bHEAlon2 Bn21wE22.n2E V11H12 VDDHE22 D DOE2 IHE Bn21HE22 COw1Vlw VH E141W14CE VCCE22terE 10 bEH2O942 MLLH 012VBIn.LIE2b * XE2 Cl 140 bVHKIwC 2bVCE2 0H 2LLE: imyr VCCE221B1'E 609 bE142O1,42 MUH D12VBInlIE2 DVA2 ObEH O 2n14DVA K WOwDNA G'1nE2DV k IrMEDHEZDVA t'•1FIngZDVA i[ -wov1. • O 2V1nHDVA bHObo2ED ObEHIwC DV90k Bn21wE22 Bn21HE22 HOnH2 _ 00 u'VmwEwE OH HvmDOn2 WV1Eupn n2ED PIS 210HEDS: ❑ AE2 AMP IEAE2' brr=V2E bHOAIDE n2106 WVIEHIVf'2 VwD Cnmu uE2= nonols oom om usEWjeEzJ: O AE2 ' . C•VWermes O AE2 If HO CICVHEl1E2 2orD•01o4bHEW12E23 0 AE2 q640 VWn2EWM DEAICE2.Ow•bHEW12E2S "q AE2 It AE2' lOJ-Vf wnWBEU ' :O HE1VIf O 2ECOwDHVIAD IJEt(fEH (2EHNCE2 O m"orE-2vrE O 0114EIS O COw21lmuo.w • Cl ummeE'. Iw2nub9ACE' uEvr E21VJ.E• • O (-VMD2CV6E' HOHliCnanuvr O WVmminuMe O wOw-buOEil J.AbE OE bn21wE2$ - bf.EV2E CHECLCIHE Vb6H0b6-1VJJ= CVJ.ECOUX t4nW8EH OE EV%fOAEE2 2CnVHE t001VCE OE amltol 22 2bVCE VIVIJIHE OE Bnemm 2 (CIIEEIZ rw4 mm LP1 Hswe WI bpous bpous Ho' EWEHCEwCA 14011E1=10t1 (EoL bwwpa Vccsae lu bmmbrucA)_ bpoue knwpeL 71w-i4)Zq- • Bn21wE22 E-WVU -G j,CZ T V40BnOME22 ME8211E 9n21wE22 bHOHE w0' (�.S2 , , _ 2 18O MY 21VIE 1VX ID 1,40- (net HO•) O 21IS61 OL bO BOX 2n116 wo' CIIA' 21s18 suq sib Coge \ wnv6 VDDHE22 SS S 81-' a�pW o trip Z 1. rnb 2PSsl 2n11s Ho• xib Caps Bn21wE22 VDDHE22 L�( 1� ' CiV )�Z Q Bn21wE22 HVWE R,pnolueas cloeea• PUA gisu8s lu 2194n2• MGM IICeu20 uadnlLeq III pnalusee cpsu8ae locsllou oL oenusLeplb• Hotl}Icsilou (o CI1A ol; Egwoug2 tadniieq bsullea couceweq• 14 uo wlggle uswe' blesae luglc9(e pI1 MNEluB MWyl• 818u suq tejm.0 sbbllcsllou nn11p }es' blesze sgn12e of IH21KnCllOw2: blesae cowble;e 1ps obbllcsglou lu tnp suq uWcp 1pe 4ednlwq 11001. blow Wlggle lulllgl oL uswe Lednluaq of 9p Bf ik 21C 2HDas1e Ees b9lq % leqI OseeCn OEEICE n2E OwPA JSJ 2,, VAENnE MOISIH' EDINOND2' MV 880S0 bHOME= 4S�-112'S2S2 cuA CfEYK.2 0E6ICE' 8171210E22.f ICE02E DIAI21014 LEE: $432400 Bf12m.M nCEW2E dbbricviiom- COWWE 6avr k.?, C11.A OL EDWO14DO L t ADDRESS Street Apt No., Unit No. City, Stale and Zip Code HOME PHONE NO.1 1 DOL NO. (DRIVERS LICENSE NO.) OR OTHER ID NO. DATE OF BIRTH CRY AND STATE OF BIRTH COUNTRY OF BIRTH PARTNERSHIP -PARTNER I NAME Last Flret MI ADDRESS ' Street - Apt. No., Unh No. City. State and Zip Code HOMEPHONENO.(_J OOL NO. (DRIVERS LICENSE NO.) OR OTHFdi ID NO. ' DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH PARTNERSHIP -PARTNER 2' NAME Last Flml MI ADDRESS Street Apt No., Unit No. City, Slate and Zip Code HOME PHONE NO.( f DOL NO. (DRIVERS LICENSE NO.) OR OTHER 10 NO. ' DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH NAME OFCORPORATION l.'G�1J��`��)(AIC QFEDERALTAXIDN0.24-1�-►(o�iS'y114 ��� CORP. ADDRESS_ S J t A U E S . EpKi ON DS) �A . 1 BOZO PHONE NO.(y,5C�O Street Suite, Apt., Unit No. City, State andZ p Code ' CORPORATEOFFICERS: Last Naive Hret Name MI Tide O No. LOCAL � 876 G94 MI Idle; Phone No. DOL No. (Drivers Lia No.)o! o. J BUIWINGL)EM O'APPROVE ❑DISAPPROVE GATE -SIGNATURE. - OCCUPANT LOAD' 8UILDING PERM(T OCCUPANCY GROUP ' COMMENTS. FIRE DEPT. "GAPPRQVE 0DISAPPROVE DATE SIGNATURE. ' COMMENTS POLICE DEPT. O-APPROVE 0DISAPPROVE DATE _ SIGNATURE' COMMENTS ., :. .. .. .: • - .. ,..' .. ... i I QQ I�'z{ DN 43 A� EIHE DEWHIMMI CObA rEIlE8 WEEDED ® AE2 ® NO rEIlEH NEEDED ❑ AE2 ❑ WO d 8 8 d 8 DV1E: 3 1 HECEIAED D1260211100 3 1 S e HEInbo HECEibl e S e ME: 2ECIION 2 J 12 CODE J 2 rEl1EH 2EWI wnneEH d NOftllIOV12 NOrtllIOV12 ME: 102bEC108 COWIVCIED: bHE-CIIVIIOW ClltlllOVl 122nED DV1E MbEC1O8 DViE 3 IV12bEC1OK S CONIVCIED: CONIVCIED: J bEH2ON bEH2OW DVIE DnE: bE820N DV1E DnE: C8tlV11ED 10 DVIE DnE: CITED M HE-MbEC110N Su4 HE-102bEC110A EXIEM210H 61NVr 8E-I142bEC110V1 AIOrV110V12 8 , 8 e e 2 2 t. ` J J HVSVB02 EOnAD VVID rOCV1ION2 \•COWWnNICV110V12 EAiE8 CODE ONrA OVICE ► AIOrtl1I0N CODE LIRE EE 1 VIVNE Ob MbEC108: bE820N COWIVUED: 10111Vr MbECAOM ME KEA'VCCE22-5: ENEBeEMCA- J en2IME22 OMME.H: HMO& V4iFG VDDHE22: I:gwouga wvlrlv�e •�. .i d 22�t3 ��� � Bn2lME22 VIVNE: F=gwC uq2 H0wG2lG9cl C0UGG rocVilow: 442 21P VAsuns Sze 180 ! HONE bHOME: HONE bHOME: HONE bHOWE: 8os0s0 R WHE DEWBIWE141 JSJ 2iH VAEV1nE Vr • EDWOVID2' MV2HINelOV188050 • (452) 111-0542 CIlA OL EDINOND2 bHOME: ISNIN253 VCJJAE . nLiH ► DV1EDnE ► I��Q���o 2CHEDnrED I 13d d1 '� LH onEWCA 21V110N 8 2HIE1 2dbEIA 2f1HAEA EIHE bHEAEMIIOVI