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25 HARDY ST - BUILDING INSPECTION , fRASIALw4ft A/PROVOO aY ME J�L�il1�A`.�111�kO fiRA1fT�D CITY OF SALEM x�qo olwld idwatlea b 1Yoik OWlal'?� YM Ido� 1�y�i� �aC� /-/®�drY `�1 M POW"Loabd In b OawwoaM AfeW Yam,_No ■EANO P�APPLrATM POW Pamlk a: (Ckft VA JW W ar apply) Ro aad k M 8Wft ConabYot Dank Bhid, Pool, Year: i PLL4M PRL OUT LMMY i COWUM LY TO AVM OYLAVO N P000UN- TO THE INSPECTOR OF BLUDU 08: ' Tin undalalpnad hweby apple a for a pomik a bWW a000rdita Yw,tolowklp �O J i wners Noma Ile u se', ,> .ram h e, Addlaaa A Phone �- " 7,-H e.r s l-- /S ( AA ll y —�®XY/ Am~* Nina / //o Aditn a Phone ( 1 MaolWVU Name - Aditn A Phom LL114� oq c f�✓� ma M b pmpM d e~ md"d at AN Dd M a , for law dmm IIIoaM1 L ° C YY�lurdrq osdaai b brA /V ' �MlwrMd oo�l� d 196, '=� IIOIIIM • c-S 8 Ewa L*awoawt a.�o ! �PPkoNY 1,1E P�IALIY' op Pam olSCRIP11oN OP WOW TO OE 0011E AW le e e v v,,;7 L' oaf Al e e decV /a ,:lr Q2oeea .S' `/ %v✓ ,P7C, ' J Tyr 0 No, APkJC,ATM FOR P! l 70 } y , WVA1M I- PBMAIT 04 © /llO w l � is �. M16PEC'TOR t �. t boo we.tyw vl a JOHNS can" X..A.&02111 Ceerswirr ' Workers' Comperwadow Isswam/lffli w* 4 ' . . widr.o PrieelPd Place of bedew AN P Fto4S[a'f- she SpV44 4v,&4S ti do llereby'cerdy undw sps rho and Penddes r ielIVIfe tree , 1 an w empioper ""MINIF worllera' cos;emsdse osvelads fw UW siwplel a wesking eel . di ask 1'.scembl,636rwK _ �%as`• W c oop sYT-oS-' Insu anes COMPNW raw "Umbet I wn s cols aroprksw and how me owe wwkbq W me IN cep► =Pedq. O i son a ado vroi*ex, general conmesw or homeowner (drde am) and hove iced du ceseraaors iind below who•heve the foliowiag workers' Vellidew . . �� Inwrswce Caegwgd* , Con baw Isuarsnu Cons"W/FoUT Member Conasaw Inswsww Conrpsq/ Ntsier () 1 am a homeowner performing all the work mYmff- 1 unswra"sew i CM s/di wMww we M jwwarew w ow Cdn A b wltw w Of ON M Iw co wow w lkodm ON M t&se w ww� c~sw aw/NMw N1.f Sadm 21A d WA 15 1 cm 4N Y ew wwsiss e/vbMb a sssde wwo&q d e fA d a M tJMM ese/er ees n,,,•;y, ,A • ss.,ry ypwmas STOP WORK ORDER rw$itel sICOADeaatbwwe. Signed this • S dry of - _ 2C7 :iccrsceiFcnnnce ismlacn� GePart ent Ljccnsing EoarL Sekecmees Office :inch Depsrmcrt ruauc rROrKNT4 OWAtaTMDrr (ao namomeTan anon sao FLAoa mi u MA of a�o Tat.(978)749-MM amr.Soo FAX (9M 74040" sTArasrMATworrei. .Jn., _ _- - ----- ---- CO DOPOM M DF. M A"WAVU b c000 &wn wit the povW=dUM c 4%SK I aclmowlo*that r a am"m al'lht Pamit/- .on dab&read ft Som UNDO="a dit P"n"by thin Bum P®it abad be dGs"W din a paap ft& o "w"wa ft dLpmd he ft.r&fWW by)M c lq SllO& The debrla wID ba dlapoced d at: �dr;, F=W S PemritApplie� Dab FLiLLY oamFkb tha fbnowhtS hduWoa: MLBAM PRM CZ.BA MY) xma dPamrit AppNow 11061fe "9/, - I, -6 0 6L Phm?&=%grow S°/ l v,n�Ei^ U� e a/i1 ✓�/� Add<ar.��Sane Mw above atatnb req*w that debris Ram the dmoN&% rmovatio4 rehab or other alt(aatim otbofl ft or Broome be ftoa d is a popady-boned eond.wa b diW" 5d5ty a,do&W by MC'i3,cl,SISOAv and the buU ft Pon"or tieeoea are to iadiedr 60 kadm dos 8a3ry.