PLANS
R~~
CITY OF BOYNTON BEACH
PLANNING & ZONING
TITLE FORM
DATE: 2' ~ (0 - 2c-oj
PROJECT# Mr)tsP o'1~o'-fC[
PROJECT NAME: "R~0')1N\. ~AS.E:. It l
PROJECT TYPE: V"t#J6L fhoO"::>IF tC:J..r/OAJ ~Tf
ADDRESS: --1j1o N ~1Vli-1USS. ~ re...-
O Commercial [3'Residential ErNew
PCN 0 i(. Lf-~_&./~ .11~IS ~{)()c.j-Ooifc;>
STATUS: A/fli6v€-l>
r
STATUS DATE:
tJt ~ ()(~~7
t-~
DESTRUCTION DATE: U
.
o Miscellaneous
o Addition
o Renovation
0'Revision_
II.JTe.fLSE C-T1 o,.J
INDEX OF DRAWINGS:
SHEET #
(ex: Sheet A-I)
SHEET TITLE (PLEASE PRINT LEGIBLY)
(ex: Floor Plan)
t 2- -STA11f P
..) ~ Z 2 - 2ur;;7
20.
S:\Planning\File lists. file procedures\Procedures\FILING PROCEDURES\p&z TITLE FORM.doc