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P - 37121�x3.S�C#�4I15 �� DA ,�� Slf'k�AUDR�$S �, �' � —� �us ne�.�ehrnr � n _Y__.� a�or�xx' `o�wwx�a� �� +-� � A A Y�nCI SUB1vItT A CUY'Y OF XUUR 5i'A,'1�L[CEI�iS� aV11'f� +APP'[dCATIC�aV �� / i From: 7637805011 Page: 1!1 Date: 12 201011:13:14 AM � ��•�� i��,r��L� �E5I1l��i.L APPI.,�CA'�'I�N �I�.'X +a►F �IiID�E� �M . �_4�� Q $�3�� n�sc�s wo� ��rcva stzE o� u�tov�xrr_ 9QUAi2ES e7�::._. x. �-*•� .� r��- .,. i! ' � a) 1a i�a.� � Yi+�yl Ci Aiw�iumm - a orher - - - — I13� OP�IV�NG'S es ONo OR E•Uxt k��V 4PPi+1ll�iG"�� S1ZE OF O�k�l[DiG C�k[�iGE5 dk Pc�rnit R�ceiv�d I3y: ,-� .� . - -- YCx[lR l"rMAiLADI?R?nFSS - - 0 ��Q�" Q SIDIN6 �' 0 HflUS� dt GARA�� A'�ITACEiGD Cr�IC+H ❑ ll►�`ACEIID f#ARl�Gk �1' � � ��T :. ' _ � �t.l ��r r , �1 � � y•�• �� 'a .' 1 f�` f ►`: 1 ■ � �^ � � 5.� . ♦ . i . 1 �Yr . _.� /. �p�YjY) I.�IT OSOfft 1O�' � 1� �j � O �m ,3. L�� p,'r., tt r�► �; E, r� �� u�+�m�r aF wwnc�ws .�.�.ft.�t p,� i c. � a o c s;FSMrr.- f. �tigtinBPloar�'Im► 2. P1�apo�e8 floor glan 3. I�st aT sreacturgl m�embels 6a he t�sed !�R i,1�9P C�?NS'�LiJCTtUI� INGi.[IDII�G Dk�GKS. a��?rac � r+r�c ci �• t. stta Pl�n+s+:rrer sllq+riflg me wsiedng anraca,res and P� P�'� Z. '1'v�o seta of can�tfon pl�s �. �y rdc��aao� ALL �ES A�tE SAi3E� �l�T VAi1TA.T��QN, ING�.�,IDING'T� cvST OF LA�R AND MATE�T�AIS: (US��,'�� .9�? i,T.R.G k�E SC��fiILE) i�r�mit F�e �ian �t�view Fite Stn�+chgrge Su�h�t'g� �.iccnse Surchasge SJ1,C C�ar$� G�rtb Cut fiscrovv Erosion C.ontrv� P'�i� �e+e Sewer, Main Charge See �a�cdc �ge f4r �ee Scliedate 65� af Buitdng Pcrmut �me .00� timcs the botal job vatuation .UU05 a Pettnit Ystuation� ll�iinitnutq $.5'Q 55.00 (ataoe IaoerNSOd Residentisl Conn�ctnrs) $3.675 �ex SAC Unie {P'i�►s Co MVYGC �or dete�►ioatios� �,.�t+ 6 ft� .. ft x $Z1= $ 5�50 Ccn�tseivation P'Isn IGeview �ee Determtined by �gi�ree�ing A�reem�nt �� C) Nrm Neoess�ay f) ` z�s �,� r�uc.nrtor� ��, �r t+�ar vnim t�s.�.Rtocsss� 1 her�y apply fctir a i�uildit�g permit aad I�cictxnMled�e that tt�e iWFprtt�tion ahov� is �mpiete ar� �a�e; tlr��t the vwrk w'rll be in car��m�ncc with t�e ordi�a►w�s asud Cxxics �a�'the C'iity a� FritAey mid wxi�► thc A+Tntteso�a Co�ostruction Gbdes: that I ut�derstan�d thi� is not �; permit but only an application for' a pert�iit an work is aot to srart �vith�ut a pexmit; that the wotk wil). be in ucoardanee with ti�e �ved p1an en the cas,c af ali wur reqanres a�d al c� pfar�s. SIGNATi1RElJF'A�'PtiiC1W'T NAMF �.I � I��'(,,,,rDATF,,� ��„�� .