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FILE # I_
110.ME OCCUPATICN PERMIT APPLICATION
(Reference OrdinancePassed
=1-'-
AP IL I CANT
ADDRESS
TELEPHONE NUMBER_� �
TAX MAP #
TAX LOT ZONE DESIGNATION
BUSINESS NAME
ADDRESS
BUSINESS TELEPHONE NUMBER _—
NATURE OF THIS REQUEST. BE SPECIFIC.
o00-
100-1
.�- — —
This application shall be submitted to t e P i e f
review. Certain conditions may be added t � c of thi
permit . You are hereby notified .
Prior to commencement of business , you will obtain a BuSiness License .
LICENSE NUMBER ��7�-1�-�� ----- --- ---—--- — ---- --------•