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teni(k. <br />EMMAdI857 <br />Certficate of Occupancy <br />��, �. _ , acting on behalf of the City of Centerville in the <br />capacity of AA -A" T-ASaYe lAr hereby certify that the <br />described premises And project have been iri d b myself and the permit or use as authorized by the <br />reference permit has hasbeen completed in omplianblOth y all applicable codes and ordinances and is not in variance <br />with said application antsupporting data as of the date of said inspection. <br />Permit # Use and Occupancy Classification: _Q <br />Type of Construction: _ALL3 <br />Building Sprinkler System provided: Yes X No <br />Code Edition in effect during permit issuance: a 6 7 /)75 <br />Property Address:10 0 LAel-N 4 � jt <br />Lot Block: Subdivision: At <br />Owner's Namez- <br />Street Addlress:�30 kk�. r1 C Lac <br />ec <br />�701 S tipula tions nd CondNons* None See Attached <br />Signature: <br />Date: IQ <br />Finat Approved: XYes <br />Owner or Contractor's Signature: <br />Subject to Sod and Grading Escrow per Ordinance: - Yes Amount: $__Z_W) C _, <br />Received By: Check Number Receipt # <br />n <br />