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28080 APPLICANT TO FILL IN INFORMATION WITHIN RED LINES•USE BALL POINT PEN ONLY CITY I)FCUPERIINf/ nuu.uwr..r:IA!1.nucnl. rrrsM11N11. 28080 ^ O O nuILDING 1MVISRIN' APPLICATION/Pl?RNI I. rlAlnunrvr.nu�.cuewcAl. IIDUA)INI;1'1111,I&:1MEN nFICATION III IILIIINNAIIIIIt P-[S: V : I001 I S5NI1'ARl'No'. At-11 AIIONSORNIHIAI,11\I1i •//� �J�x� c t/ I Ia5 Z •^O�OO `" 'G��J ���a /����V/�� IINII'x / IIIIXSO3 TNIc \1111:: NE TSL! I:IINIHAI:IIIK' nll II' 1,: NII' R('OWG I/l(NI;INITH SIC N(F. ADDRESS cM FillIL-MIFS F�INNlnitq n IN'I'Al'1': Pnlllns: BUILDING VERMI'I'Ill R1 �5/1 yy''�� I r ��, ��I k7 X105 Q'I'Y. IiLECI'ItIC I'IiRMI'I' PCC t�Ma/`-V DIxN/T'I 3'O•�fDI-"T�� 111.1117 111.11'1 1'11011 All❑111 / VK II'I IS.SUANC1i IL-1 Hit FNISRIIIONIRA('I11R.SI)11(:LAIAHON Al-I'I.IANIITS-RP_CIIIENIIAI. 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