6 LARCHMONT RD - BUILDING INSPECTION ili—
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CITY OF SALEM
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BUILDING PERMIT APPLICATION FOR: '
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(Circle whlohewr%W Roof, Remof, IMM SWft Co sVwt.DOCK Shad, Pool,
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PLEASE FILL OUT LEGIBLY A COMPLETELY TO AVOID DELAYS N PROOElI
TO THE INSPECTOR OF BUILDING&
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Signature of Appk w t
SION40 UNDIIR THE P
OF PERJURY
DESC1 N OF WOi1K TO BE DONE p
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