HomeMy WebLinkAbout078-280-013A.P .--96-821 _2 —
WALTER J. STOVAL PERRY,' H.T. +
x3041 Oro-Bangowy._,__Oroville 1092-67B
+Permit 1661-73B,E
¢(addition) fiVxgI ia-07
A•-- - i Near 3043 Oro -Bangor -
Halter ,Walter J. Stovall i 1� il� % f g •, sou h & beh
church, Oroville n
3041 OroBangor Hwy., Oroville (demolish 2 Bldgs.)
Permit 1836-74 (RENEWAL of 1661-73)
,ate IJ /I
E R M 1 #55
15'1 FoL 4755 5) _
r
Permit ##47 5-75B (2nd renewal for
permitr%
Permit #6478-77V,F,,M(class A Flue,
plum-ing, elec. & mi C.Cl; cle up/SF)
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PERMIT N0. 6478-77B,P,E
•
PERMIT EXPIRES
OWNER Walter J. Stovall
CONTR. owner
LOCATION (A.P. 36-021-2
3041 Oro.Bangor Hwy, Oroville
Temp. Power Pole
Called PG&E
Temp. Elec. Serv.
alled PG&E
Te p. Gas Serv.
Called PG&E
jos1W
(' S
FINALED
(Date)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd) PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
StemwaII
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwa i i
Insulation
Heaters
Slab
Carport
Footings
Prov. for phy
handica ed
Conformance of ex. sically
structure
Appliances
Gas Piping &Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf..Steel
Final
Fixtures
Stucco I Final ISubDanelS
L
Scratch Heating Service
Brown Cooling Temp. Pole
Finish I Ducts Underaround
Door Closer Final Final
MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal
Water Piping Sewer Gas Piping
MOBILEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity
Water Piping Drainage Gas Piping
DATE REMARKS OR CORRECTIONS
� '-4
pr 11-1,
(NOTE: An entry must be made on this, form each time you visit the job site.)
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County Center Drive , — OroviIle, California 95965
Tel eplrone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Dat
Siture of Permitee or Agent l
Receipt No. �6 k2_:? _3
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.
DI 7C fJF PUBLIC WORKS
N G�k/i�[/s_ Date 1-2 -/3- Y�7
permit expires Date 1-2
BUILDING
Owner teAS 5Do
SQ. FT. OCC. BUILDING VALUATION
Mai I i ng Address v
I.S O T leph e No.
Fireplace
Contrac r
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
®�
Building Address O
PLUMBING
No.
@
FEE
PERMIT FILING FEE $3.00
l�
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. �p --b�
Zoning & Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
Fees
W.C.
-FireDept.
FireZone
Use Permit
Building sewer 5.00
EQA
Plans Parkin
Declaration
Parcel Map
60' R/W
Improvements
Lawn sprinkler system 2.00
Bldg. P'on•s—Rued
Parcel Approval
Plans Approval
Permit Fee
$
,sZj
j
NEW ❑ AQ8IfjON U ,,1_LLTJ LI TIES ❑ OTHER
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
3,
• — /
Main service ;000V OR 0 AMP LESSOR 5.00
✓ e
Main service EA. ADD•L 100 AMP
2.50
Single Family Duplex ❑ Mobil Home ❑ Others ❑
OVER 600V
Main service 00 AMP OR LESS 25.00
Main service EA. ADD•L 100 AMP 1.00
NEW CONST. / DWELLING OCCUP. &
OR ADDNS. ( ACC. BLDGS. )
2¢sgft
.
NEW CONSTR. MULTI -OUTLET
NON-RESID. ( BRANCH CIRCUITS) '2.50ea
NEW CONSTR. POWER APPARATUS &
NON-RESID. (SINGLE OUTLET CIR.
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:
Ex. Occup(OUTLETS OR FIXTURES) BAL@1
Ex. Occu FIXED APPLNS. OR
p.(OUTLETS (RESID.) EA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
a 6 .�
;q
1 am exempt from the Contractors License Laws of the State of California.
Permit Fee
$
9,.Z
$
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.
Elhave 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
1z 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 $
$
1 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
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Dat
Siture of Permitee or Agent l
Receipt No. �6 k2_:? _3
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.
DI 7C fJF PUBLIC WORKS
N G�k/i�[/s_ Date 1-2 -/3- Y�7
permit expires Date 1-2
r /83fr_
PERMIT NUMBER _ g 1661-73%!E
P
Y f E
PERMIT EXPIRES �Z3-7T
t �10WNER Walter J. Stovall
CONTR: • owner
t LOCATION (A.P. 36-021-2
3041 Oro Bangor Hwy. Oroville
c
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i
COUNTY OF BUTTE
r Department .of Public Works
BUILDING INSPECTION RECORD
Zoning, Setback d:9 49z, — `f� Forms
.Foundation Piers & Girders Fireplace
Rgh. Plumbing Bond Beam Lath & Plaster
Rein. Steel . Gas Piping & Test Found. Vents
Framing Plmg. Topout Rough Elec.
Wtr. Htr. Furnace Kitchen Vent.
! Firewall Garage Vents Sanitation & Water.
ELECTRIC GAS BUILDING
Temporary 'Temporary Cert. of Occup.
Final Final Final
DATE
REMARKS 'OR CORRECTIONS
�y �!=?,
M
• COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS i '
7 County Center Drive — O,roville, California 95965 �y
Tel ephone: 534-4541 [[
APPLICATION AND PERMIT In
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X
ate
gnature of Permitea 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 OR/RUBLIC WORKS
By Date�'l(' 74 �CXilding"
permit expires Date ���
BUILDING
Owner t
SQ. FT OCC. BUILDING VALUATION
Mailing Address
- Telephone No.
Fireplace
Contractor
Total Valuation
Mai I i ng Address
Permit Fee
PI an Checking Fee &/or Penal ty
Telephone No.
Permit Fee
Building AddressPLUMBING
No.1 @ FEE
PERMIT FILING FEE $3.00
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. 3 — ad/— Q
Zoning 8 Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
Seoke4+eA
Fire Dept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma p
60' R/W
Im rovements
p
Lawn sprinkler system 2.00
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION ❑ UTILITIES OTHERELECTRICAL
JAd
No.1 @ FEE
PERMIT FILING FEE $3.00
Aa1-73
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
2
Light fixtures bl"a 10
Receps„ switches & fix outlets
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: 4r
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
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 $
$
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
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
$ Z
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X
ate
gnature of Permitea 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 OR/RUBLIC WORKS
By Date�'l(' 74 �CXilding"
permit expires Date ���
• COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
7 County,Center Drive — O,roville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT
,51�'7, 5
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspectio",;
,x 775
S' ature of Permitee or �,nt
Receipt No. . �0�q iWhite-D.P.W. — Yellow -Assessor — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County de and/or resolutions to do work indicated
above for whi els v be aid.
UBLIC WORKS
Building permit expires
BUILDING
Owner b �' � .
SQ. FT. OCC. BUILDING VALUATION
Mailing Address36
1
N
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee&/or Penalty
Telephone No.
Permit Fee
Building Addressy
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00 @-p
4Fj
Each Trap 1.50 -57—
Repair drainage or vent piping 1.50
Water piping 1.50 S
Each gas water heater or vent 1.50 /J"
A. P. No. 3 3— G
Zoning & Planning
Gas piping. system 1 - 5 outlets 1.50
Each additional outlet .30
Fees
W.C.
I Sanitation
I Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I Parcel
Declaration
Parcel Ma "
p
60' R/W
Im rovements
p
Lawn sprinkler system 2.00
Bldg. Plans Rec'd I
Parcel Approval
Plans Approval
Permit Fee $ '��
,
NEW ADDITION UTILITIES ❑ OTHER
001
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
GP-'
Main service incl. 1 meter
6 ! �.Or , S
Additional meters, each 1.00
Sub -panel 02 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 (d2
bal20
Receps., switches & fix outlets 0 25
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Di.v. 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
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
ul I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
is
MECHANICAL N0.1 @ 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.
-50I 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
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
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspectio",;
,x 775
S' ature of Permitee or �,nt
Receipt No. . �0�q iWhite-D.P.W. — Yellow -Assessor — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County de and/or resolutions to do work indicated
above for whi els v be aid.
UBLIC WORKS
Building permit expires
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WOR
V3 0��
7 County Center Drive - Oroville, California 95965 (7
Telephone: 534-4541
APPLICATION AND PERMIT
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X e Dat3-N
Signature of Perm tee or Agent
Receipt No. Z z2-Z%S
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/RUBLIC WORKS
By Cl V _ Date,. ` —7
�C/Ilding permit expires Date.............�.a� ....�
BUILDING
Owner atrE :3 7—
SO. FT. OCC. BUILDING VALUATION
Mailing Address 3o O /v.41
el ephon a No.
3-- 17 57
Fireplace
Contractor `c
Total Valuation
Mai I i ng Address 15 .0v /,!;F.45-
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee
$
$
Building Address30 �� _
PLUMBING
No.
@
FEE
PERMIT FILING FEE $2.00
OU/GLC=
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.Zoni
ng 8 Planning
Gas piping system 1 - 5 outlets
1.50
Each additional outlet .30
FAe<
W/(''
Sagi.PR'l'fon
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
60' R/W
Improvements
P
Lawn sprinkler system 2.00
Bldg. Pla�ec'd
Parcel Approval
Plans Approval
Permit Fee
$
$
NEW ❑ ADDITION UTILITIES ❑ OTHER
ELECTRICAL
No.
@
FEE
PERMIT FILING FEE $3.00
•
Main service incl. 1 meter
D _
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 1@ 10
T
Receps., switches & fix outletsbuia 10
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. lisp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
ense 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.
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.
MECHANICAL
No.
@
FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
1 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
$ s
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X e Dat3-N
Signature of Perm tee or Agent
Receipt No. Z z2-Z%S
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/RUBLIC WORKS
By Cl V _ Date,. ` —7
�C/Ilding permit expires Date.............�.a� ....�
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO 1,661-
7,37 County Center Drivp — Orovilie, 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.
Date
Signature of miteee or Agent
Receint N(n_ D / ! C 6
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 PWBLIC WORKS
By %Y�e�—{�� Date's—_Z3-7 X
Suildiny permit expires Dates;? i,.
BUILDING
Owner /
SQ. FT. OCC. BUILDING VALUATION
Mailing Address 30
Telephone No.
Fireplace
Contractor
Total Valuation
Mailing Address
Permit Fee
Plan Checking Fee &/or Penalty
Telephone No.
Permit Fee $
$
Building Address ��
PLUMBING No. @ I 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. Q '. `- 2,
c7 '`
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
yes"11 19—If
San ation
Fire Dept.
FireZone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
Parcel
Declaration
Parcel Ma P
R/W
Im r
p ovements
Lawn sprinkler system 2.00
Bldg. Plans Recd
Parcel Approval
Plans Approval
Permit Fee $
$
NEW ❑ ADDITION UTILITIES ❑ OTHER ❑
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)
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixtures bolJ10
Re s., switc es & fix ou ets i roto
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
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 $6
$
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.
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
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date
Signature of miteee or Agent
Receint N(n_ D / ! C 6
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 PWBLIC WORKS
By %Y�e�—{�� Date's—_Z3-7 X
Suildiny permit expires Dates;? i,.
BUILDING D
A
kk
'�
e'-�,2�-�3
this set of plans`an- 'spec#icat�ans`NII�ST be--�'.
-- kep ^n the Ok at all times and it- is unlawful to
make any changes or alterations on :same without
— written permisson r . is
1 County of Butte.
' ui tcy;nui— ..
t44 ao _Ienb e
e "mad .- q4!m -Qw t
--
--- -�
- — -
-- --
— —
ui a8 IIe4S, diysuewjjoM v
s eijo4m 11v—:31q2N'
`' I
iw.ad 'eon
uQui
wog} '4} OS pue .;Dull Afaado
d a' is act
BUTTE COUNTY
DEPARTIAENT OF SOCIAL WELFARE
TO: Dept. of Public Works/ /
RE:: Name: �QGGIIlq Sr o vo
Address: 30q I Oro Hwy
Oroyi Ile' 1 Ca 95 y,s
Finding Directions:
Date:
/I - IS. 77
Request: Please verify the need for the following:
CLQ .
a�/ C��C� i,u^�� 7 C.l�2L y�� �G (�.' : t.! t � �tc < � �-ft-�•(� C�C,� Y�j '�
y�56
Social Worker
TO. Dept. of Social Welfare
Date:_!2
Recommendation:
-
d -f
,( 1�
3.
• C Cil! .w o•.-:..� C1 _ �' _. A
�rVsp ec for
uttseCounty Dept. of Public Wore
INSTRUCTIONS: Complete in triplicate. Send 1st and 2nd copies to Dept. of Public Works and retain
3rd copy in Welfare Dept. Upon completion of its recommendations, .Dept. of Public Works will return
2nd copy to Clclfare Dept.
B- 116