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HomeMy WebLinkAboutBuilding Permit #188-15 - 74 WILLOW RIDGE ROAD 8/22/2014 O�No oT BUILDING PERMIT 3� b�,,• "� o� y w... TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATI Permit NO: Date Received Date Issued: 'L C ��SSACHU MPORTANT:Applicant must complete all items on this page � k Q�' 3 Y` TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑New Building ❑ One family ❑A jdition ❑Two or more family ❑ Industrial Iteration No. of units:, ❑Commercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other 4n SpC ❑:1Ne11 C7I� plain ❑1�leflarids a 1Utersed Distrfct;F pMYlaterlSewer 'r n O c'OELIc Tb Li�lYL d.F J-I C)cJ ST G IdentificationPlease Type or Print Clearly) OWNER: Name: 5 6RLX; )i,�/ �,.s4/*► Phone: 1251 -3bo -a& �___- Address: �©NTRAGTOR Name _ Phone eAddress � ueis�l``s=Co�i; tlrc+en fl $ +lame improvement��censexp �Date _} ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ (0 000 00 FEE: $ Check No.: I&h Receipt No.: NOTE: Persons c ntracting with unregi r c actors do not have ac` ss to the gu ranty fund Signature of''Agent/Owner. `Signature of contractor