3 WITCHCRAFT RD - BPA .t
No..
APPLICATION FOR
PEWW TO
LOCATION
GRANTEDPERMT
Zoo,
OO
OR OF BEALDWM
1
*W*n111WIE f KAD4*0 APP RGvED aY TW
PINIXI TD A."AW ARM QRANTLD
CITY OF SALEM
w.rd
�a.era
a Pfaw"y Loomm In
b Mimic OI~ toaotioo of ff
YN No aius,e 3 cRAFT
ft C~Mon AMO Uk�No�
Permit to: Mq BULO Pum APPLICATION FOR:
(Circle**how apply) Roof. dNjai, Insiall Skimp Construct Oeolf. Shsd, Pool.
RspaM/IaspUoa, Oafer:
PLEASE PLL OUT L MLY A COMPLETELY TO AVOID DELAYS N PROCEBWq
TO THE INSPECTOR OF BUILDING&The nrim ' '.
hereby applies for a pamk to build acoadinp.to the ftlwm rq
sPeoilloomm
Owws Name w M a y7ck \ Z
Address a Phon. _� 1�,�� � `t R� (4ig► ��+5- I'9q
Arohksct's Noma
Address a Phone f
Mechanics Name
Address a Phone f 1
v"Is n.P■*m of euramgr
klo w a hvr&W c��v�c o o N•dwc■rq,for how mww Omani
MAbAdgGWftmfofor✓r VACS A 9 \}p
End=d 19 M LW�• sUb of •
25 Ltn. A ,J t.,
SWAM of A~
BIONEp tNNER TILE PENALTY'
oESCrypr1ON OF WORK TO 9E DONE Of PW&RINY
ll<PMc,Fr2 � OBI �m�
MAIL PERMIT