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SA\TA <br />{\.{"",,;,1 <br />Pbrntng end luldllre AgPmY <br />nurfnf Dtulrhn <br />Z0Cffi C.rt?Pls <br />P.O. tor tE (I.2O)!..r.4lr, CAanOz <br />rr.| a.7{toauuu,]L{na.oag <br />CERTIFICATE OF OCCUPANCY <br />SUPPLEMENTAL <br />QUESNONNAIRE <br />Pllrrrin h <br />Corpatyllr: (Prin) <br />lqm wltt @l/dfirrlte d OccuPncY qppllcaton' <br />Contad Nrne ue.-cLs <br />Ad0t3t (hrirrcs maalng a<ldrees)2 2 (I Ar-d s*ru* <br />crr .rfrp(?+ ,4..n/ t <br />Ptrr- js.Z! Lg ? 2 VYO E<nal Ad<helt c <br />E ChmgcolPropcrtyOrvncrp CtranecofOccupent D Ctrrmpof Urc ! Addnionel Occupanl <br />l. Th.lbloxllp Ddd..crlbrl my oprnUon: <br />E oiloonty tr Rafisrhs fl ledlceuDontel <br />El MdnerDbtrlhrton fl RateurenUTekr Ost Food <br />Elgttr tcccaorl 5 L*V u ,r_ <br />ST <br />this <br />r- <br />&/- <br />2 PlcE plttad. r Ddd Oas?Uon of hou th. hriness opontes st this sito (br erample, pleaae <br />doclb Al gEttrd nCutt d lho h.lsinolt, what activitbr occur on-site, fig irourr ol opore0on,oe'nbrtptfio)' /*n io vd (t /')te_lyr t ( ol," H *1 <br />3. UYilrrOI foltnctlPo d hrhess or u!€ dfadlity? (A68$ a ntdthe leaong a4,ent or bd6nguu b cbbtntn phr Danirss us.) <br />vDfl@ilYtal<4= <br />l. llr. lh. hrdhg a spme been vacant or is this a new buildng? yes E No E- <br />,tyr.ri, hrhtrlme? <br />5. Anyouuridcpandantcontractor? yes E No ( <br />0. l-cdonofthchrrrecaandeuitenumber. 2L3o Vl 7e <br />& t.noor fl 2-ttoor fJ _noor <br />7. Do you shd0 rte lbor or busirnes entrance wrth another business? yes D No,h, <br />E WH b thc arnor.nt of egusre fodage leased? <br />9. Fhmucfi d0re epa, hfii$ 1ou hase, is office? <br />tr ioogt tr 5oyo tr 30% DL uess than 3o(./o <br />tf o0ror Otan 10096. lrow s the remaining space used? <br />t <br />p-3 <br />*