HomeMy WebLinkAboutX2020-2400 - Permit Application (3)k-omm-i I . KeSiaenual
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Description of Work
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OWNER'S NAME
Last -
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Owner's Address C-C
a Owner's E-mail Address
City 1 ic�. -- -
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ZIP - Telephoner
APPLICANTS NAME -
Last First
Applicant's Address
Applicant's E-mail Address
City State S� 15-�«:L a�'Go s1��j EC)°, s1:<
�Vi 4 ZiP of Telephone
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ARCHITECT/DESIGNER'S NAME i
Last First �-
Architect/Designer's Address - _, Lit No.
Architect/Designer's E-mail Address
City _ _
State Zip Telephoner
ENGINEER'S NAME Last t L
���t\ i�V ACL First— Lic.No. '
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Engineer's Address-
- �-
Engineer's E-mail Address
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city, State
Sa Zip (����r� Telephoner
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CONTRACTOR'S NAME/COMPANY
Lic. No.
Contractor's Address -
Contractor's E-mail Address
State Zip Telephoner
SETBACKS REAR SETBACKS FRONT
�— PERMIT NO. r 4
SETBACKS LEFT SETBACKS RIGHT pp
�— 9®. si• N ;CHECK NO.
USE ZONE PLA:-
DEVELOPMENT N Q J
-(:Fi`ECK FEES $ —_ H