13-101917r
RECEI\D •
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redMAY o 12ot3 PERMIT sir MP CO ME PL DE EN
Federal
cowitinor�:��a �s of FEDERAL v yPLICATION
253835.2607. CD
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SEESAD EEss SOSIE,Cars a
3 5\14 Carn s 'r 1- .r�i IN WA- 10)3_
P>pouaecrvsl t oil ASSESSORS TAXIPAROSL 0
/000. oo ArT)M09f L _& (2_ - Q.
0
TYPE o�PERMIT
0 D O 0 PLIIIBG 0 am
/l OUIION 0 t! 111E PREVENTION
IWO OP PROJECT Cv.-1 en par- IL
PROJECT DESCRIPTION e2
Detail gio
ed&sxripn ewark to J Lr//TGif our O/t/ „C"-Gl ‘fmtteei,/27-$/2,•Q- /Q•'l2--
bet-eluded c.t t3&pen»itaaly f ,l/� ,1 c$ /2,¢b/o
SOWN MAIY614 CA C9-le,P6rk_ L LC-. a,15 a• Lel a/
W CA rylgA,S Ne- 115013 Lao E tS
Creitletrd 1iNi6 %5 3
PRIOTECS I OS-)�a x5a--3018- 105 2
WARREADORESS CONTRACTOR v220.2� reams AvE S 814 r8 NoreencOate
exlT
suss me o PAX/e6vr' I ar,P '1°3 aS3-8-1 -44(1
�raaduasootetseetoe aacaassi DAIS staounozoraasoamaaotaasa>nast
F R-0 7 E o 4 e%3 3 7 P / 2 , /9" /9-9 / 577-c0-Bt-
PROM
APPLICANT xeaarssooats S saran.
CUT I SEATS I at INS
PROJECT CONTACT
fll:e
to rnce3ucvad Poa Rao s5 T ;e953 .3`�8— (aS
n3sP"td ED g OOrr�cat= IlflOB >t GsE Co$ri7 I./L?s /C7 s I y sum.
`RT/�'� 18o3 a— '"
44 8Are,� ,�-art-oago y .t3 x
eP ec ,44 A
PIECTIY(ABCDPC EMIR yPC
Required cokeofAS.000 or more
taCwtsrraa9 etsnaNGAZOR a r SUER ZIP PROM
r
Icertar mad=persalte Qfp«3wp that t awl the.spate acme*or armth rived w ote property owner.I ter*);that to the best
slag knowledge.the lar reapetioa submitted In support el this pasrdt appbloatiaa is true cad correct./eat*that I vont comply with
all applicable Cite of Federal Wag regulations pv0ahabes to the work aselitorised by the ierseants eta permit:I maderstaad that the
moot of this paved does not resew the Carew s nesposesibirtag Air enepHarace with least, same. arfiedmaL Imes regrla tbv
construction or essiroareentel lards.
1jiathe r ounce to hold haaroless the egg cererL ral Wag as to duly slain gaelecti g assts.uponut&maid ottoraeys'feta Lured be
- the investigation and defense resod'claire),which eddybe made by tag peso=haciediag the w+ .aradjlied agabott the°9b
but only where such staid►aloes out of the rollout*cj the chg.iaadading Its boas and employees.apes the neee rasp of the
isjbnencica=applied to the city as apart ends - f
• nuerr mute__G ac i Salk 1)
Bul ctie#100—Jaunty 1,2011 Page 1 of 3 IcURaOcloutsTanik Application
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