54 LINDEN STREET - BUILDING INSPECTION 54 LINDEN STREET
CITY OF SALEM
DEPARTMENT OF PUBLIC SERVICES
REQUEST FOR CURB CUT
DATE OF REQUEST: C7 r-r-bac,;r 20 , ( "-
REQUESTEDBY: 97fML 2osenF?E147 PHONE: Cyd - ZSSri
LOCATION (as specific as possible):
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LENGTH OF CUT: ify Ci<cnT
COST PER FOOT: $8.00
INVOICE TO: _ E7}}FL /C�SGN�� EZP
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FICE USE ONLY
APPROVED BY: / BLDG. INSPECTOR
DEPT. OF PUBLIC SERVICES
NOT APPROVED: DEPT.
EXPLANATION:
DATE OF INVOICE:
PAYMENT RECEIVED: