HomeMy WebLinkAbout208 21ST ST - Building Permits CITY OF COSTA MESA - -
°�05 ,p BUILDING DIVISION
:t 'l O 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov
. .° FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBER: BC12-00111
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: DEMO ALL DATE ISSUED: 02/17/2012
ISSUED BY:
JOB ADDRESS: 208 21ST ST CM Suite/Unit:
APN: 42614140 Zoning: ,
Vicinity: Primary 0cc:
Const Type: SQ. FT: 0 Valuation: $9,000.00 . - ..
SCOPE OF WORK: DEMO RESIDENCE&GARAGE, 835 SF DWELLING, 175 SF GARAGE, ELEC, GAS,WATER,SEWER CAP I
OWNER: JH ORANGE AVENUE LLC Address: 208 E 21ST ST Unit: - -
Phone: City/State/Zip: COSTA MESA,CA
APPLICANT: DAN POWERS Address: Unit: :
Phone: 714-557-7901 City/State/zZip:
CONTRACTOR: TIGHT QUARTERS License No. 584915 3C12-00111
Phone: 714-557-7901 Address: 2031.S ANNEUnit:
Cell: City/State: SANTA AN,CA - ZipCode 92704
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ARCHITECT: License No. PHONE:
ENGINEER: ROBIN B HAMERS AND ASSOC. License No.C31720 PHONE:714-548-1192
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $108.71
Building Fees: $167.25
Electrical Fees: $41.70
Mechanical Fees: $0.00 . _ ....
Plumbing Fees: $52.90
SMIP Residential: $0.00
SMIP Commercial: $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES: $371.56
"Refer to fee receipts for all fees paid for project
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays:
New Years Day,Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§ 1;12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
coos 0 INSPECTION TYPE INITIALS SOH A INSPECTION TYPE 294INITIALS '
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall _ 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
. ..°.rr.n;:aliva y6:
203 Final Sign �/ 222 Final Site
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204 Final Demolition /t 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
V) I have and will maintain workers'compensation insurance,as required by
section 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: (l • person is required to descend,will be made in connection with work authorized
LA-IL 1, 1� _. r. /� by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: vim. 'NV Ill I VIS i nciA.-C2 Co- or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be completed rt the permit rs valued at one hundred dollars(5100)or fess)
r !`0CJ� n I _V1,11 2,Art 2,Sec.341,Title 8,California Administrative Code).
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Policy Number: tl •
❑ As owner-builder. I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers'compensation provisions of Section 3700 of
the Labor Code,I shall forthwith comply with these provisions. Applicant's Signature Date
Division of Industrial Safety Permit Number:
Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
X LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is infull
ct Class# C. 2.l (gd
full force and effect. - a registration form for acutely hazardous materials? 0 Yes 0 No
Lia 5g4 ) f l7 -Dot.(Section 25533 of the California Health and Safety Code, with some
9[-') exceptions, requires registration with the Costa Mesa Fire Department by
(INS (fiA/'/,(�+-- 7, ' I1'L 7 _ each business which at any one time has on hand a quantity of acutely
Contractors Signature Dale hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons. or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑No
Lender's Address: (Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑ No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for 8. (If'yes", attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer),
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec. 7044.Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
ID I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
{c \Signature o Le I Owner(s) Date
Signature Date \ J/?, �_ 'Z_,7—tZ
A
305] 6(3/07)
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And/or Authorrzed Applicant Date
PROJECT ADDRESS: 208 21ST ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 062897
OWNER'S NAME: PRIOR
AOORESS: 208 21ST ST PERMIT NO: B 062897 PLAN CHECK NO: N GOVT: N SUPP: N
C.M,
CA CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER:9 2 6 2 7/6 4 6—4 4 0 2 flEG.ND.:
JOB DESCRIPTION : REROOF CO)IL
ADDRESS: UNIT: S Q FT:
CLAIM VALUE: 2, 000. 00 CALL—VALUE: 2,000 . 00 GROUP OCC:. R-3 /
1 PERMITTEE:ROYCE W. PRIOR ( 714 ) 646-4102.
ADDRESS: 208 21ST ST COMMENTS: REROOF WITH COMPOSITION SHINGLES
I. + CA 92627 *************�r�E�r****+E�r�r****�E�L**�E;E***�E�r�6LF*�E+E�E�P�E;r�E1t***sE�E**** f iLY. �45.
C.rr. �+ng�
LICENSED CONTRACTOR DECLARATION: I hereby affirm thatnam licensed under provisionsd of Chaplet 9(commencing with Section Z O N I N G REQUIREMENTS IVI r
7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. S E T B A C K Jr t 1+�E--D
CITY LIC.: STATE LIC.: CLASS: R v t �+.
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING RE • PROV; PARCEL: 42614140 ZNE: REF NO:
Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TES>
>
Date: Applicant- ************************************************************ ******************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is foe one hundred(5100)or less). D E V E. L O P M E N T SERVICES R E Q U I R' E M E N T S
I certify that in the performance of the work for which this permit is i d.I shall not employ any person in any manner so as to become
subject to the W rkers'Compensation Laws of California. L ZONING APPROVED BY •
r-- (� ‘6/621.4.01 / DATE:
•
Date: Signature:
NOTICE.IL after making this declaration,you should become su ed to the Workers'Compensation provisions of the Labor BUILDING APPROVED BYSthCCSCGj `
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. A / J DATE:
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; 1,:j.;:y
�'/ DATE•which this permit is issued(Section 3097,Civ.C). *****.****.************* * ' ** r**** *M**** **** **********it*3, **
LENDER: s************************ ********************** *****************************
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 45 • 00 ,50
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5141P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE. FEE
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 45 . 50 0 . 00 0 . 00 45• 50 45 . 50 • 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.II,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 45. 50 OVER/SHORT• ,00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45. 00 • 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *,*.*,***.*.****.*.*.*,*,*.*.***,.***,*.***.****.************,**,**********************************
That proof el their Worker's Compensation insurance should be provided to me.
1amexempt under secuom.BP7044on: B.aP,c. INDIVIDUAL F E E BREAKDOWN
lor this�s WORK HY OWNER /� � TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
�--' Date: Owner: W
I do hereby certify that I am aware of and understand the requirements of Catilornia Health and Safety Code Sections 25505.25533,and SFR 2000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 000 . 00
25534 and that 1 m any future building occupant will/will not(circle one)need to comply with said state codes and the requirements fora il END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions
EXPIRED
Date: Applicant: Incomplete
herebycertify that i have read this application ion and state that the above information ist Lives of I agree to complyterwith all city and boned (�.,t', t Inspections
ordinances and state laws relating to building construction and2autndrrepresentatives of this city to enter upon the above-mentioned IL art �/� 01 00142320-00142321 TOT 45.50
property for ins ection urposes. l lJ
,0 f3 �O DATE: 07/06/93 TIME: 14:15
Date:_7 / signature: Q
Drivers License or Social Security r P
1641-46 White—Bwldmg;Green—Code Enforcement:Canary—ApplicanB Pink—Revenue:Goldenrod—Assessor lP J
CONSTRUGTIU J ;AND PLANNING POOL ,PA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •
•
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines,P-Trap, ❑ Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
• 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70, Underground Hydro
22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test ' 72. Underground Flush
24. Roof Framing . . .73. Undergrnd.Storage Tank b Gas ❑Oil
25. Roof Sheathing / 3 U g__ 74: Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat l 7 C/" 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe •
28. Lathing & Siding •
i 77. FIXED SYSTEM FINAL
I. .
29. Insulation I. 78. FIRE PREV. FINAL
30. Drywall Nailing .+ t- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •
•
33. Final Electric Notes:
34. Final Heating& Air Conditioning ( I
t I
35. Final Gas Pipe-Test
36. Hood or Canopy - •
37. Final Factory Fireplace -
38. Final Plumbing
39. Water Service-Final
1 _
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backflow Preventer I I '
43. Backflow Irrigation�t
44. Landscape Irrigation System
45. Sound Attenuatior4-
46. Handicap Regulations ;
1 -
47. FINAL STRUCTUREB&BUILDING
48. FINAL PLANNING :
Tz
49. Electric;fielease to'Edisoa'
50. Gas Release to Southern California Gas Co I •
51. CERTIFICATE OF OCCUPANCY
No. Date
THIS PERMIT IS ISSUED
irieciOUNTY OF ORANGE _ SUBJECT TO ANY FEDERAL - •
BUILDING DEPT. RESTRICTIONS. PermitNo� 3 OSO
636 No. Broadway Applicatn or Building Permit
Santa Ana, California
Phone: KI 2-6211 AND FOR A
Certificate of Use andA
. Certif `/J /�Date /(� /% -1/
I. OWNER'S NAME qC�L� 2 PHONI Dry‘�
MAILING ADDRESS--.-L `� ' Ginit_ CITY /! ed- ,-
Name Name.__ -
(Architect or Engineer) ��� 49 �v •r) .__ ,
Address Address en
�(,-
City City ��(/_Y/C_ > • . .
State State C� y fS�
Lie. No. �� Phone Lie No. _ _L�_.7•• 3 Phon U
PROPOSED USE: ' 3t4 1Z 14. .0. a'`�' /�-- �jJ� ,_
2. JOB LOCATION O O `o • tyl _� • . '__ ��M�"T�r4et..• - 1
• (House No.T//C S oil(WL-.7 '457(5€-t./f�y •,, •r�lhdSCUifl4er) �f3
•
3. LEGAL DESCRIPTION: Lot z S3 B(o / .- '-_Tract
(Metes and Bounds Description—Use reserse side of form)
4. CORNER LOT ( r ) INTERIOR LOTT (•/) THROUGH LOT ( ) SLOPE OF LOT (( )
5. SIZE OF BLDG.: y -11)( 3o AREA:-__D -a 0 D SIZE OF LOT:7.X/O ° AREA:_2u o 0
/ 7r• cite_
6. HEIGHT OF fed- CEILING HEIGHT• ,/ NO. OF STORIES d'YL
� -__-
7. NO. FAMILIES. �— Size of Smallest Bedroom: _1� K.1 l Size of Kitchen: -7_X
8. EXTERIOR WALL CONSTRUCTION• INTERIOR WALL COVERING ,
(Frame, Stucco, Etc.) ((Plaster-Drywall, Etc.
Center SETBACKS: Front Yard from Center Line of Street J "---
Nearest Side Yard IC-- Rear Yard S0 /.Distance in Feet Between Bldgs. on Same Lot__�12 -P1Z Lc..--
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width /T X Depth in Ground i
4,1
Width of Wall
Accessory , d
Bldgs. and (b) Size of Studs: 2- X S"/ Spacing /l "CC Material of Floor._einataC
Similar
Structures:
(c) Size of Floor Joists: Spacing "CC
(d) Size of Rafters: Spacing . "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, paint-
ing and sewage disposal $ r-Crysas
13. I HEREBY CERTIFY THAT TO THE-BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN
THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL
LAWS OF THE COUNTY OF ORANGE AND THE STATE� OF CALIFORNIA APPLICABLE THERETO.
Signed:-`� /C /
Owne
Filed- 2 —
Plans 9 ✓r r)
By•
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHE ING BY
�,�� GROUP L
Bldg. Permit $ APPLICATION HEALTH
Plan Check - $ -3 e° TYPE £ FIRE
ZONING MARSHAL
Total - $ 77 ems_ DIST. PLANS AND-..f f /
4Receipt No. - - 47„.,________ MAP SPECS C/uQ•t-•--STATE
Paid to .;_af,
f/. SHEET NO CORRECTIONS ENGINEER •
Date ___ _ _V.ERIEIED CAL
/ - p
PERMIT
/ISSSS�UED Y:
DATE ! )- _ ,r/ X05 -- L ="UTY
CM-7.50
METES AND BOUNDS DESCRTPTL
110 210 310 4,0 510 610
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