8 LEMON STREET - BUILDING INSPECTION i
8 LEMON STREET
CITY OF SALEM
DEPARTMENT OF PUBLIC SERVICES
REQUEST FOR CURB CUT
DATE OF REQUEST: /9 7
REQUESTED BY: .a+k-"G 1, Conn ors -PHONE:-7
LOCATION (as specific as possible): k- / err,on s t, y �, w,'/ I 6.
D h ` MOSS _tt. S+dG P 4- A 4,se
LENGTH OF CUT:_ 0�0 �t
INVOICE TO: I IIJK." k Cg Jj ors
------------------------------------------------------------------------------------------------------------------
9RaF ICE USE ONLY
APPROVED BY: / BLDG. INSPECTOR
DEPT. OF PUBLIC SERVICES
NOT APPROVED: DEPT.
EXPLANATION:
DATE OF INVOICE:
PAYMENT RECEIVED: