121ADDRESS OWN ER
i -P * ?N , I - � C3 -dab
OCCUPANCY
12 May aar r C e Certificate of Occupancy:____
LEGAL DESCRIPTION
Lt 13 Bl.k G Country Club Manor Unit PB11 Pg 100 Date Approved:
SUIL WNCKCONTRACTOR
- � .ry /c
Tcpu Reg's. Apply: Yes No '...
J BUILDING:
12 -27 -78 Permit
BUILDING RECORD
Final Inspection
Montgomery Ward
roofing
! 19 ,. Gr /C
01100)
FEES-
Development Fees
9 - 29 - Permit # 23134
1�...� —fib
{ _:. �
Streets Paved Unpaved
Randy Allen Roofing
Street Paving Fee
Reroof 5/F Res
UTILITIES:
{$2400}
Water Lines
Meter Set
Sewer Lines
Sewer Tap
Storm Sewer _
l°IIGINEERINO /PUS. WORKS:
Drainage
Street Paving
Street Narne Signs
Street Lights
[OVER]
Maintenance Bond