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-COUNTY OF BUTTE —Z DEPARTMENT Of PUE,LIC-YVORKS
7 County Center Drive —. Oroville, California 95965
Telephone: 533••1230, Ext. 259 "
APPLICATIO14 AND PERMIT
autnuncerepresentauves or ine Lounry os tsurte to enter upon ine
above-mentioned property for inspection purposes.
M
Signature of Permitee or Agent
Date
Receipt No. —
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building Permit Expires Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
Fireplace
Contractor
Total Valuation
Mai I i ng Address
Permit Fee
Plan Checking Fee &/or Penalty
Permit Fee $
$
Building Address
PLUMBING No. @ FEE
PERMIT FILING FEE $2.00
--
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No.
Zoning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .50
Fire Zone
Fire Dept.
Sanitation
Planning
Building sewer 5.00
Plans
Fees
I W. C.
R/W
Encroachment
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ OTHER ❑
Permit Fee $
$
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
USE OF STRUCTURE Single Family ❑ Duplex ❑ Others ❑
Range, dryer or water heater 1.00
Oven, Cook -top or space heater 1.00
Light fixtures 2Q 2
Receps., switches & fix outlets 20 @25
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F.A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Misc. wiring
s
License No. Classification
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$ ,.
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Inst utate mentof ontrpn groonion $0.07/$1000 Evaluation
$
TOTAL PERMIT
PERMIT FEE
$
autnuncerepresentauves or ine Lounry os tsurte to enter upon ine
above-mentioned property for inspection purposes.
M
Signature of Permitee or Agent
Date
Receipt No. —
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By Date
Building Permit Expires Date
COUNTY QF B&TE — -DEPAR-TMENT OF PUBLIC WORKS
7 County Center Drive — OroviIle, California 95965
Telephone' 534.-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X LOZt,4 ate `?- 3
Signature of Permitee of Agent
Receipt No.
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR 0 PUBLIC WORKS
By Date. _/_7 a
Building Permit Expires Date )—/— 7 Y
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address xe, -
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Permit Fee $
$
Building Address
PLUMBING No.1 @ FEE
PERMIT FILING FEE $2.00 a..
Each Trap 1.50
Repair drainage or vent piping 1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. ,�
124 'ng s_N
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .50
Fire Zone
Fire Dept. Sanitation-, 412 .'
lanning
Building sewer 5.00 f
Plans ,/
Fees ��
W. C
R/W
Encroachment
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ OTHER ❑
Permit Fee $
$ �✓'-°
a
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 00
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
USE OF STRUCTURE Single Family ❑ Duplex ❑ Others ❑
Range, dryer or water heater 1.00
Oven, Cook -top or space heater 1.00
Light fixtures
Receps., switches & fix outlets ER
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F.A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Misc. wiring
License No. Classification
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
01 certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
InslrumenrationtrY a anion $0.07/$1000 Evaluation
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X LOZt,4 ate `?- 3
Signature of Permitee of Agent
Receipt No.
White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR 0 PUBLIC WORKS
By Date. _/_7 a
Building Permit Expires Date )—/— 7 Y
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive O,oville, California 95965 i
Telephone: 534-4541
APPLICATION AND PERMIT
CULIIUrlLC Iellre5e11lGIIVCJ UI me LJuunty ul t5utke lu enter upon the
above-mentioned property for inspection purposes.
X�"/' Date
1,
Signature of Permitee or Agent
Receipt No:
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR, OF PUBLIC WORKS
By Date-
BUILDING
Owner — ; sa;. U•,
SQ. FT. OCC: BUILDING VALUATION
Mai l i ng Address
�
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee '
$
$
Building Address ���� ��,,, o' %��
PLUMBING
No.
@ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping
1.50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. _ - ���
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fees
W.C.
Sanitation
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
ImprovementsLawn
sprinkler system 2.00
Bldg. Plans Recd
Parcel Approval
Plans Approval
Permit Fee
$
$
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL
No.1
@ I FEE
PERMIT FILING FEE 1 $3.00
,
.. -'_ i ,, ��� � ��
Main service incl. 1 meter
Additional meters, each
1.00
Sub -panel (12 or less) (more than 12)
Single Family ❑ Duplex ❑ Mobil Home ✓ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater
1.00
Light fixtures b20
ald15
Receps., switches & fix outlets lu 25
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. FanorF.A. Furn. Motor
1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
I am exempt from the Contractors License Laws of the State of California.
Permit Fee
$ "
$
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
ElI certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
MECHANICAL
No.
@ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
TOTAL PERMIT FEE
$
CULIIUrlLC Iellre5e11lGIIVCJ UI me LJuunty ul t5utke lu enter upon the
above-mentioned property for inspection purposes.
X�"/' Date
1,
Signature of Permitee or Agent
Receipt No:
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR, OF PUBLIC WORKS
By Date-
141 :. -,; ;, 41.
Owner 00, l
Mailing Address
Contractor
Mailing Address.
Buildina Address
O_Zz)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
• 7 County Center Drive
Orovi Ile, California 95955
Telephone: 534-4541 .
APPLICATION AND PERMIT
BUILDING
• SQ. FT. I OCC. I BUILDING VALUATION
A.. P. No. 9 5— J_
Fire Zone Fire Dept. Sanitation i fanning
Plans ✓ Fees c� W. C - R/W Encroachment
NEW ❑ ADDITION ❑ OTHER ❑
USE OF STRUCTURE . Single Family ❑ Duplex ❑ Others ❑
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Fireplace
Total Valuation
Permit Fee
Plan Checking Fee &/or Penalty
Permit Fee
PLUMBING
PERMIT FILING FEE
Each Trap
Repair drainage or vent piping
Water piping
Each gas water heater or vent
Gas piping system 1 - 5 outlets
Each additional outlet
Building sewer
Lawn sprinkler system
Permit Fee
ELECTRICAL
PERMIT FILING FEE
Main service incl. 1 meter
Additional meters, each
Sub -panel (12 or less) (more than 12)
Range, dryer or water heater
Oven, Cook -top or space heater
Light fixtures
Receps., switches & fix outlets
Hood, Ex. Fan or F.A. Furn. Motor
Evap. cooler, gar. di sp. or D.W.
Air conditioner or heat pump
Water pump
Misc. wiring -2
@ FEE
$2.00
1.50
1.50
1.50
1.50
1.50
.50
5.00 f
2.00
0®
n�u�t
rola
License No. Classification
al am exempt from the Contractors License Laws of the State of California. Permit Fee
WORKMEN'S COMPENSATION INSURANCE MECHANICAL No. @
PERMIT FILING FEE 53.00
am aware of the provisions of Section3700 of the California Labor Heating
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
�( I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
.
X Date `� -3/
_7
Signature of Permitee o Agent
Receipt No. �O �� ''Z'
Cooli
Ventilation
FEE
Permit Fee $ $
Ptote Fee tation rogrom for Strpng Motion
Strumen$0.07/51000 Evaluation $
n
TOTAL PERMIT FEE $"
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR 0 PUBLIC WORKS
BY Date % �`_
a
1'LI�y �j-23Itza
J
COUNTY OF BUTTE = DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Tel ep9 one: 53A-4541
APPLICATION AND PERMIT
BUILDING
Owner ' SO. FT. OCC. BUILDING VALUATION
Mailing Address Q
Telephone No.
Fireplace
Contractor Total Valuation
Permit Fee
Mailing Address
Telephone No. Plan Checking Fee&/or Penalty Permit Fee $
Building Address /" S PLUMBING No. @ FEE
PERMIT FILING FEE $2.00
Q Each Trap 1.50
Repair drainage or vent piping 1.50
F OK Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. Gas piping system 1 - 5 outlets 1.50
Zoning 8 Planning Each additional outlet .30
%e -es I 4<�witetieA-1 Fire Dept. Fire Zone Use Permit Building sewer 5.00
EQA Parking Parcel Parcel Ma 60' R/W ImprovementsLawn sprinkler system 2.00
Plans Declaration p
Bldg. Plans Rec'd Parcel Approval Plans Approval Permit Fee $ $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00 r,> O
3 "' 73 Main service incl. 1 meter
f Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
Single Family Duplex ❑ Mobil Home Others ❑ Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixturesbal 25
Receps., switches & fix outlets20 25 lb
CONTRACTORS LICENSE LAW. Hood, Ex. Fan or F.A. Furn. Motor 1.00
I am licensed under the provisions of Chapter 9, Div. 3, of the Evap. cooler, gar. disp. or D.W. 1.00
State of California Business & Professions Code under the name Air conditioner or heat pump
style of: Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00 s
'
License No. Classification Misc. wiring
® I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE PERMIT FILING FEE $3.00
1 am aware of the provisions of Section3700 of the California Labor Heating
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of Cooling
Workmen's Compensation Insurance.
i I certify that in the performance of the work for which this Ventilation
}permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of Hood 2.00
California. Permit Fee $ $
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date / /W
Signature/off Per itee or Agent
Receipt No. r ( J
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
TOTAL PERMIT FEE is 00
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIREC OF PUB WORKS
By Date Z'`/ o
Building permit expires Dat --.1(,>?
-J
eawf* q.i3ufte
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: John B. Lewis
ADDRESS: 5072 Clark Rd.
CITY & STATE: 'Paradise, CA. 95969 IMPORTANT:
November 30,'1979 SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT ' RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID .DELAY)
AMOUNT
i
Owner (Conrad Springer). decided not to install_mobilehome on...
property. Permit 39 2- 9MHI.- Receipt #25150 = AP 71-16-
• o
Mobilehome installation permit fee ----- $30.00
Retain. 173 of fee ----------------------- 10.00
AMOUNT OF REFUND DUE -----------------=-.$20.00
$20,00
TOTAL
$20
00 1
I, the undersigned, declare under penalty of perjury that the services or articles claimed have b perfo ed or delivered,Inthat this
claim is true and correct as stated. ........ tom...�C baled Chis i•�C—.--�. 1�iav19 C.t !J:'.�.. Cslif. %_ r_ o �,_��
igna !. ;m
1. the undersigned, hereby certify that, to the best of my knowledge, the services or arti es specified above have been performed or de- I
i
livered and that there is a Budget Appropriation a or Specific Board Approval (Check one) for the'same. I
Dated this .................................... day o. 19..... at Calif.
Department Head or Authorized D eputy
Dept. Exp.
Code ............................................ Code ................ ................................... PAYABLE FROM ...................... FUND
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
VENDOR
CODEI
DEPT.
8. SUB.
PROD'
SUB.
I OBJ.
CLAIM
NO.
INVOICE i INVOICE
NO. DATE DISC.
I GROSS
AMOUNT
ENCUMB.
SUB -DIST. t
I
COON Y UTTE — • DEPARTMENT OF PUBLIC WORKS
'• 7 County Center Drive — Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
39y�-79
authorize representatives of the County of Butte to enter upon the
above-ment' d roperty for inspectionpurposes. �`�►
Z�Date
Signature of Permitee o Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS .
By
Building permit expires Date
Date
BUILDING
Owner
SQ. FT. OCC. BUILDING VALUATION
Mailing Address
C222.ek=x 92
Telephone No.
Contractor
Mailing Address
Fireplace
Total Valuation
Telephone No.
Permit Fee
Building Address
Plan Checking Fee&/or Penalty
Permit Fee
_
(vArr �{
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
Each Trap 1.50
Repair drainage or vent piping 1.50
A. P. No. —� .�
Zoning &Planning
Water piping 1.50
Each gas water heater or vent 1.50
Fees
rN.e: Sanitation
Fire Dept.
Fire Zone
2
Gas piping system 1 - 5 outlets 1.50
EQA
Parking
Plans
ParcelEach
I Declaration
I Parcel Map 1
60' R/W
I Improvements
additional outlet .30
Building sewer 5.00
Bldg. Plans Recd
Parcel Approval I
Plans Approval
Lawn sprinkler system 2.00
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
Permit Fee $
.$
'
ELECTRICAL No. @ I FEE
PERMIT FILING FEE $3.00
V OR L SIS,ESS 5.00
Main service 10000 AMP ORE
Single Family ❑ Duplex ❑ Mobil Home Others ❑
Main service EA. ADD'L 100 AMP 2.50
Main service OVER soov 25.00
100 AMP OR LESS
Main service/ EA. ADD'L 100 AMP 1.00
NEW CONST
OR ADDNS. DWEC ACCLBLDGS.LING Ccup, Y) 22 sq ft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
NEW C°NSTR (MULTI.OUTL T
NON-RESID ` BRANCH CIRCUITS) 2.50ea
NEW CONSTR. (POWER APPARATUS d
NON.RESID. SINGLE OUTLET CIR.
Ex. OCCUD(OUTLETS OR FIXTIIRES B �,@j
FIXED ALNS.
Ex. Occup.(OUTLETSP(RESID)REA) 2.00
Temporary service' 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No. @ FEE
v
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
KA I certify that in the performance of the work for which this
LOJ permit is issued I shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$ C3QQC
I certify that I have read this application and state that the above
information is correct. I agree to comply to all County Ordinances
and State Laws relating to building construction, and hereby
Land Development Fee
$
TOTAL PERMIT FEE
$�O oC
authorize representatives of the County of Butte to enter upon the
above-ment' d roperty for inspectionpurposes. �`�►
Z�Date
Signature of Permitee o Agent
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS .
By
Building permit expires Date
Date
PARCEL SPLIT WORK SHEET,
/0 . /o
DATE 7-/0- ':-)0MAPPER KEYED BY DATE lO-/Z-9D PP
119 RETIRE
0 70
0 7Z/ tll4v ,- 0 7/ = X60 - 07& 0 7?(D 0 70
(3)
077
/fig —
>.,.41 / l
NEW PARCEL NUMBER Q 7I. * 60--0 7-7 & 07e/
/ /
001 STATUS CODE , %'�Ti'%L� Uel I ��
002 CODE. AREA
003 ASSESSED OWNER -1)1-01elj"GC
004 CB, LE, OR C/O OWNER
iJ
016 MISCELLANEOUS CODE
005 STREET ADDRESS
006 CITY & STATE�/?Uj��� C9
007 ZIP CODE gz�5 z-
008 PROPERTY LOCATION /. AQP_
023 BOOK & PAGE
RECORDING DATE ,
s
y
060 USE CODE
1*
EXEMPTION CODES �1m,
078 ACREAGE 7oL 7 7 70
079 SEC, T, & R _j�� 51 TZO l le 49
ETALS
901-00 DELETE
800
800
X800
800
REMARKS
801
801
801-
801
01801 /
A/O 153 Rev 1/84
i
W
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