17 CLEVELAND RD - BUILDING PERMIT APP f L Y7E Ar�d>Np APWIIOUEO I W TILE
Pill TD A.1!�!AEMKi ppAN�p
CITY OF SALEM
or.
Wod
DWA_
b Loomad in
r»�r+•re owa� r--w=� of
� 0 Ll eogeJ \-j
M PIGMIf►LooVAd In
OWSWASM Am?
Psrmk to: ■U LOMq APPLICATION POIh
(Ckole whto WW apply) �Od OWAU J Cacmw act peek mod, Pool,
PLUM PILL OW LAMLY A COWLETELY TO AVOW MAVB IN PIIOCt@p
TO THE R*N%CTOR OF BUILDING&;
sThe
Mloetlorswp hereby MVW for a pamik to build a000rditic tlre.tok W%
Owner* Name (y-i
Addrea a Phone 12 CVev eLKJ 1uCJ icm17'1
Amhbwft New
Address a Phone 11 t
Abolwrloe Name �-�o�e+Owv--
Address A Phone 90. 17o �1�60 ��c� veto jbo'�
mm , d q,1w hew mm arwanl
vm 4iate o ftm to kw?
P.drrr•>,e.ar a 10-k-)
—.,`.__�►LJonw._,_,_,taw Llonw••
�� sent TY.
oESI rION OP"rD LIE ww
Olshoye o� Q10wLIVL.WN VL
V1 S�A V1eLk)
SOI�N Ifs d0 11O10 d
�/
a3JJrV!!�JJh1!!�d
HOLLV=
Ol J nmad