91660 (2) 7373 Fallen Leaf Lane
APPLICATION FOR
CERTIFICATE OF OCCUPANCY
Use classification 4P#ArHeN-r Bldg. Permit No. 9/66'0
Croup Y Type of construction_�Jr- A/ Use Zone g
Caner SA N A /ZsF 5-,4 HDS �I
Address 73 '/.i 59'� �
Building Address •'73 7 % 4,12-E,
Portion.of building �`✓AGeK/�
FPB Approval necessary By: �4-Z.;2;9w,4i �lr ��`eel
Yes =No Date:
Disposition of certificate:
Date routed to FPB "'1" --- By:
Date mailed to owner By:
Form 280-668
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