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Siws 3a7ksiv Opting of Lied S S. se. Donny DATE OF APPLICATiCh a Fr. r O g Pone ADOPESS CF STRUCTURE Sestet R. E NDEX NO LOT NUMBER lap --Z BLOOt NvVEIER SUBDIVISION TOTAL FLOOR AREA 10 r. CONDITIONS No work shall be started until all required permits have been issued. The applicants hereby certify to the correctiveness of the above Information and agree that no occupancy will be permitted without first securing linal Inspection and certificate o.

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