BP4281TYPE OF INSPECTION ROUGH FINAL AMOUNT DUE DATE PAID
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DATE ~ ppmnrlr~l i nn
4_ ~ g_gg APPLICATION NO.: 4078
4-20-88! rtrtMl I Nv" 4281
;AMOUNT PAID: $6, 000.00 - $30.00 #77607
~_~._- -
(ADDRESS: 739 North 1 Rth Q\/PY111P
~,~~d"' LOCATION: _
JORGENSEN CONT/Thomas Churchill ;L-ot 2 Greenbriar __739 North_lOth Ave_n_ue
Inspection has been requested for '~~~1 ~~~ . ~~~~-~~
Location of Building
By IC1`1~CC~~-~'U~~ ~ t~n~V ~ ~~"~10rti~y-~~~~ ~-Ll~,~~''z.~>{i~~
Dame of Company
~(Ty'_p~ of Inspection)
ta;~~°( 1 ~~ ~a'39
At
Date
Time
Results of the inspection are: ~~
City Representative
Tncrir~rtinn hac haPn reaueSted for ~~/ /VG. /(/ ~ ~.~
Location of Building
B ...rte ~ 0~ Low . ~ I . C~~c.~Q ~Y ` ' ,~ ~
~~'> Name of Company,
'°-_
(Type of Inspecti n) ~~``~--~~
At ~-a 7~~~ ~,
Date T e
Results of t2ie inspection are:
City Representative