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HomeMy WebLinkAboutBuilding Permit Application Alt APPUCABL°3NFO`i MUST E COMPLETED FOR:APPUCATIOti,T gE kC£EPTfQ
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Fill in fee s4mpl 7me N+ai�ier©n nes t tea tf�tfferea�t E ttfEa 1 oC�-�°�-?coo�,fs .:G o M
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If,daiue of'tonstr ctaon ks 2s-W or':rr,or ,''a RE RQEA'NOtk4 of C6MMeneem6t Is`regtatred
E5lGNE2: NlNEER• iOt1pplcable; ii+E3R 1°+� E.iC#3N9 ►NY,> =NOt Ipp1iCIble
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state•` State.
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FEEl�til "t 'I LE 146 'lUc�t�pplt�able �C?N>�3t�1C�cO1ViPANYy
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ir3.WNEW ONTCr.0 AF permit 640 the work and, nstailat66 as ind"icated.
i iiy t3�at no, or ink it .ins'er� rn �; �o�.t�s.t�ae"issuanee.�fi a perar>tt
5t:tuca 'Co,unt' rr3ak 'nv r€�pk"ire entatic n that.is granting a,peft wi l authorize the errnit ht�der ire bund thesubject structure;..
v8'r ch 6s l t a» i t lith ap}�licable Home t3tr hers ssuciatatlr�rules;<b iac�r rar an co nants that°may restrict or;prohibit such
sctucturi' piease:consWiWith your i�otlsg vr� s Assrsuatir�n r tl re c ur ya r bleed fir arty rests ct pns a�hath rriay Ppiy.:
in-c90Md1pration Pf the brant ng Ear thts r quest pest, h reby gr that i vVill,'ln all
respects,perforrri the iv��k:
accord ice with the a sprr�ve ,pians the Fl im Bulldt»g, ti ar 3 5k;Ltr �t�u�aty-Ain' lel is
Tire fa ii�awing budtng ptr�s�t aiiihcat rose euempt'15rton uergong a full ncurrency revty room adti�4s,
a + ssorystrtictiire, mmarrgIal ,fences,wails,signs,screen rc>orrs awl accessary uses t another rrc>rrs!duse.
A-RNING T�,OWNER Yatir(allure to R rd a Nr� o.j.f irommencement may3�esuh in;your 3�ayrr:g tvvir�—
mr
irr roVements:to ypur�,ropert Notl of i imra�dra�cement rest be r c�rde and p need ort th "'b"' .
b, fare t3�e"first insp ct►or .".lf y pU nter>d„ta ofitarn finanang,consaalt wi ti .ier r i,a -at#ci ney be' re
sirrmenan vlork i r r cca r In Qur: li ce"� ' or»r a ct tne>rrt:'_.
'Signature of Owneq-i?sse6lcdh2ractb awent ftsr C3tiisrser,` Signature_bf Conti a r'i5c `Hoid
STATE'OFF LO DAST'A�' OMTL� :©.
COUNTY
he r ctng rn!561u e”t eras ac aua+leciged be trlre r e e.fo rr tr#stru enc va is acl noa ledged be are
tits� Gday o ` ., I��41jr ih day n€ ✓t L`� i icy
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{ tarn tlf ers ° acicnauledgin )., f i�kine of pers©n3:noxrlecl fin
ISignat a of Neta .ubltc 5fat t�l•Elor�da Sign use tsf i!icstary ic+c Stale:tit flanda:
Prsnnaltysovsrp CiR-Produced icienucaiirr. ersorally low, tR Presr3uceitent1fication
Type erg identifrcati of fd€ntiRcafia
ir'#dut3 �YP`�c KEGAN CRAWFO?R r used
SppY PUB
My COMMISSION#GG2�0 o
Comink" or :Tits,. �rJ "+;N XPIRES:October 03: o `mrssion. to.. .. 'Lfo �Jl) GAN CRAWF R
COMMISSION#GG2. 0
"toFAo° EXPIRES:,October 03, 0
LiElt4lS.. FRQTl1 (3NifdC 513PEitV15t7R Plii5 1IEt"�(ETATIi�N Sl'TRfIE IVIAI`t�EtC3�E:
;GOlt 3TEl : REtlt REVJEt ,; R 111£Vli. REV EVtt RECliE1t41: `REltiE1 ..
DATE-.,;
RECEI�tED
DATE
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