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("T, <br /> DATE 2 <br /> DBA M ox SC DO AREA <br /> ADDRESS CITYn <br /> OWNER 0:. "!2Vc- 1 PHONE 9,6- F-_3,3 !yr <br /> ADDRESS .� : CITY <br /> sially • p PHONE 95"Z. -31 Z4�r <br /> ADDRESS CITY <br /> TENANT PHONE <br /> APN LOT SIZE ' ' SHORT TERM <br /> IDENTIFY STRUCTURES <br /> PERMIT # DATE PERMIT # DATE <br /> N RECORDER'S #. GD, TD, TD, RECON. <br /> co�,oa <br /> 5 k4O l <br /> par %jj <br /> q fag <br /> £H 00 18 REV 6/83 7/83 200 <br />