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[[NO[kKLS <br />APPLICATION FOR FENCE PERMIT <br />JOB ADDRESS 9 . \i4 ,kE ()kL. 1Z..D Project Valuation $ <br />Owner's Name r �? °-t i rt C\I°-c .c <br />General Contractor ‘ c: c,.. c•.i "N -r - _r\ CZ. <br />City BYCa K!b cl f 04? te- State K t3 Zip S S (HS-"1 V.6 Telephone <br />Day Telephone <br />Address <br />t INC.) <br />License Number (note: all contractors /subcontractors must be city or state licensed) <br />TO BE SUBMITTED: <br />Plot Plan/Certificate of Survey X. (showing all easements) <br />Type of Fence Material 51 v a V L `Y c� Height 5 <br />Approximate Starting Date S <br />Signature <br />t <br />Approximate Completion Date 1 0 <br />Date <br />DO NOT WRITE BELOW THIS LINE <br />f •• <br />FENCE X <br />TOTAL VALUATION $ <br />Type of Construction Occupancy Group <br />Division Use Zone <br />Survey: Required On File N/A <br />Permit $30.00 State Surcharge $0.50 Easement Encroachment Agreement $30.00 License Verification $5.00 <br />TOTAL AMOUNT DUE $ lO j. SQ <br />Review By: % 1 i r Date: 3' ',?e3 ' ,949Q— <br />Issued By: <br />Permit# 02011401 <br />Date: <br />4 g_11_24, o 2. NpT /!s_yowC-w /N gekfg <br />Lo-r d13eMEW1- EX,5,3) . <br />L ^ L <br />1cifei3"+ME?A r AOR '741E LOT - <br />