HomeMy WebLinkAboutPermit Signage 1981-04-22r--
r-r
CIETT OF SPH,I}TGFIEIJ]f
SPRlNGFIELD. OREGON 97 477
INFOR\I\TI0N: 726-3753 Ir*SPECTIOS REQUESTS : 716- j:b9
CITY OF SPRINCFIELD
SIC:'i CONSTRUCTION fu\D ELECTRICAL INSTALLATION
CO}IB INATION APPL ICATION/ PER\IIT
LoCATIoX OF sICN(AoDRESS)
LEGAL DESCRIPTIO:{ /7 O1 2 {
.(&
TAX t_OT f o
ol{)iER oF PRoPERTY D l.Eranat.l 7t/7 e i y2rtn L.
ADDRESS llA I i/. )47n 9 ? rt nr- t'to tl
PHONE
7to
OifNER OF SICI{(IF OTHER TH,L\ PROPERTY OI'NER)
ADDRESS
I'IA.\IE OF BUSIIESS, FIR\I, ETC.
SIGN
PHONE
a TYPE OF BUSI)IESS
IGN
j; ERlcr
REI.,OCATE
ALTER
crnrER
L I{ALL
T,TARQUEE
OTHER
FREEST,{\DIN6
PR0JECTLT-6
READER BOARD
BILLBOARD
IDENTITY
PROJECIING
INCIDENTAL
DOUBLE FACE
NON- I DE),ITITY
SECCNDARY
SINGLE FACE
IIIULT I . FACE
x
x
VE:"t0RS CO)JL\CTCRS:
-,_ srcN ERECToR*1Ailtl_Arl2_lt*a5-__ .- *_-*___PH1NE_ )-/tr,/ ) L Z-_*.
A.DDRE55 e e u e <._
/2aci Fr c De e>
Clfi LICS.\-SE :\[n.l3ER
sIcN }tL\UFACTURER (IF oTITER TrL\\ E RECIOR)
EXP DATE
ADDREsS /5 i l. S t t t ( r-- E .>(1 .z
E I,TCTP.I C.{L CO}iTRACTO R PHONE
LICENSE NIIIiIBERADDRISS
t.t)1.{LLrl !.\'.tD
TOTAL HEIGHT ABOVE Gfu\DE ,'{ .VERTIC,\L DIIIENSION OF SIG:.I ..5"HORIZONTAL WIDIH OF SI 6N_/L_L.-
DI:TENSIoN FRo]r GR\D[ T0 BOTT0]! 0F STGNJS___TH ICKNESS OR DEPTH OF SIGN .9 ,,
DOES SIGN PROJEfi BEYOT-O PROPERTY LINE YES A NO IF YES, DI}IENSION BEYOND PROPERfi LINE
IiOTE: IF PRoJECTIO)i IS i.iORE TllI\ 12" 0VER PUBLIC PROPERTY TtlE SIGN ERECfOR l.iusT FILE l{ITll THE BUILDI}16 DMSION COPIES 0F
HIS PU3LIC LIABILITY [\D PROPERTY DATTAGE INSURI"\CE POLICIES.
il[LL SIGN HAVE ELECTRICAL l''IRING? _YES 4NO IF YES, WHICH APPLY? ELECTRICAL SIGN _ILLUMINATED (INDIRECTLY LIGIITED)
DESC.D.IBE fiPE OF Y.\TER,I.\15 SI6)t IS C.I,ST,.UCTED OF /,/ c T ar L L
S
,taAd
PROVIDE UL NIJI'IBER IF APPLICABLE VALUE OF SIG}I IAA
SITE INFOR\L\TION (LJ"\D USE).-EXiSTING USE OF BUILDING OR LAND (OR LAST USE IF VACA"\T)Narl6o tL9&
PROPOSED USE OF BUILDII{G OR LdIiD:
CHECK ONE IF APPLICAB LE: INDCOR BUSINESS _OIffDOOR TIERCHT\DISING
IF YES, DESCRIBE ALL E-XTSTING.SIGNS..FoR BIJSINESS"EXISTII{G SIG,IS (SiGN CODE) : AiE TTIERE EXISTING SI 4t _N0
FIRI, ETC.:6 LO
GNS?
,{,
AI,L EXISTIIIG SI6NS 0N PREIiISES(S,j"UE TtuX LoT)
I HAVE CAREFULLY EXi.\IINED rhe coEplered application for peroi.t and do hereby certify that all inforroation hereon. is true and
correct, and I furrher certify thir all work perforned shall be done in accordance with the Spri.ngfield Sigq Ordinance, the
Unifornr Sign Code as adopted by the City of Springfield and all other Ordinances of the City of Springfie.Ld and the Laws of
the State of Oregon pertaining to the work described herein. I further certify that ny Sign Contractors License wi.th the
City of Springfield is in full force and effect as required by Springfield Cit,y Codes 8-2-6(J) and 9-7-2OL2\. I gill request
all required sign inspections listed on the approved pernit.
tZl .. ,,DArE 4-2.2--81NA},{E (PLEASE PRI}IT)
SICN DISTRICT
L SIGNA
ZONE DISTRICT TOTAL SQUARE fOOTAGE OF SIGN LrO,
INSPECTIONS REQUIRED SITE,/ LOCATION FOOTING OR IIETIIOD OF ATTACH,\TENT ELECTRICAL
ELECTRICAL PER}IIT:
CIIARCES: _
FINAL - OTHER
SIGN PERTIIT
CHAR6ES:| {,oo
FEES:
TMAL FEE FOR PER\IIT /4" oo
STATE SURCH1R6E
\
PLEASE i'tD
l) seo:rete siqn Aoolicerion: A separare application is required for each
separ3Ee srgn rs derrneo in the Sign Code.
2) Flectrical: Any pernir issued under this application will include wir-rng rn or on stgn structure, the supply wires for connection must be
covered on an electricrl permit. Electrical connection must be madeonlv by I sraie Licenscd Electricel conrractor. Illuminated signs (bothinternelly and e.rrernelly) must conform to Seccions 9-7-.1 (4)6(S) and9-7-13 of che Springiield Sign Ordinance.
3) Plens Reouired: This eppticacion is ro be submitted with two completes"ts oi pirn-drern ro iiale, showing dimensions and heighr of sign; ad-vertising nessage on sign; locari.on of sign on properEy with dimensionsto propercy lines, srructual details of support framing, bracing andfoocings; neceri.als of constnrction for sign and sign itructure; elec-tricel equipnenr and lighring; size and loiation of existing signs onproper!r for the sa:ne business, all as required to deter:nine compliancerrith the springfield sign Ordinance (Article 7 of the springfield cityCode). Also, shou the r'ollowing infornation on the plot plan (pian
showing properry lines and location of signs):
a) Show 3hg locacion of all existing sign(s) as well as proposed sign(s).
b) Shore the length of the street frontage taken up by the business or
buitding.
c) Shov the locarion of entrances open to the public and driveways.
4) lihen required, beceuse of design, size, etc., engineered drawings_and
calculerions nust be prepared by a licensed engineer or shall conformto desrgn scandards on r-ile at the Building Division Office.
5) Plans of insufficiens clarity or detail will be returnej to the ap- :
pticenc vith no perniE being issued.
6) signs nust neet corner vision clearance requireroents as described inFig. 9 of the Springfield Conrprehensive Zoning Code.
7) liorE: lio sig.n nay be erecred which is less than 12 feet horizontallyor vertic:lly fron overhead electrical conductors in excess of 7SOvolts, or less thin 5 feet in any direction froa overhead electricallines vhich ere energized at less than 750 volts.
S) If e si;n is nos insrrlled r;it,hin 60 days after the date of issue ofthis pcrnir, rhe perilit shall be void.
9) fnsoect ions:
a) Site Insoection - to be laced. Usually,
e at the samection
\LrD.iII0:,r
made before the sign is p
(if applicable) may be roadtine Js che S
oade after ho
nspeccj.on. The Footing Inspection is to bele(s) is excavated, but prior to the placement of CLERKconctet e.
b) Final [nsoection - co be nade upon completion of a1l work.
c) Electrical - All elecrrical signs nust be inspected for electli-cal hook up efter the sign is erected and before the sign is
turned on.
c.r[L FOR ]HE REqUIRED I]|SPECTIONS ON THE 24 HOUq, TNSPECTION LINE AT726-3769. ::
SPECIAL CONDITIONS TO BE SATISFIED BEFORE ERECTION OF SIGN
DATE
ADDITIONAL INFOR\IATION NEEDED BEFORE PER.I.,'IT I,IAY BE ISSUED:
PLA}TS REVIEI{ED BY:DATE
\
INFORTATION:726-j753
CIITTT OF SPF,I\TGFIEIJ]f
SPRINGFIELO. OREGON 97 477
CITY OF SPRI.\6FTELD
SIGS CONSTRUCTION AND ELECTRIC:L I].ISTALLATION
CO}IB INAT ION APPL ICATIO}I/ PE R\IIT
L\-SPECTIO)i REQUESTS: 7:6- j;o9
LoCATIo.Y 0F SIO{(A0oRESS
LEGAL DEscRrptrox B- oZa ,€4
OX\ER OF PROPERT't.
ADDRESS -oir\-ER 0F SIC5(IF Crn{ER T}LL\ PRoPERTY olt'i{ER)
F t t t, Er c . _ D I t+H o D >_-Z- DrE*. Nhll o Nti?furrus
TYPE OF SI
TAX LOT 4
PHONE
oo
ON
-Nc
7
ADoRESS__
NA.\E OF BUSISESS,
ERECT
RELOCATE
PHONE
I}JESS
CHECi: APPLIC.LE
ALTER
crnlER
I{ALL
r_ RooF
-_ !,!\RQTJEE
OTHER
FREEST,L\DiNG
PROJECTI,T-G
REAOER BOARD
BI LLBO.{RD
IDENTITY
PROJECTING
INCIDENTAL
DOUBLE FACE
NON-IDE)JTIfi
SECO}iDARY
SII{GLE FACE
IIULTI. FACE
X
X
VEStsRS CO);TR,\CT3RS:
slcs enecron \'7tfp tTtP BroS 5/lns PHON
ADDRE:s-lx !4- *
CI I Y LICST.SE
sl6:'l IR\UFACTURER (IF OTIiER TIL{\ ERICTORI z I F /c Uec.u
)aDREsslLL6_5JUL/l-__qocazryg-e_."e,A-_?xts__
EIJCTRI C.\L CO$TR.TCTOR
ADDRESS
EXP D{rEli 3 o=
PI{ONE
PHONE
LICENSE NI,I}IBER
Oo
DI}!E\SIC:iS I ]iST-\ LL\i I CS .\\ O CC:;SiR,UCT I OI'I I NFOR}T{T I ON
TorAL HEIcHT ABovE cR^DE ,/ o 'I'ERTIC.{L DI}IENSION OF SIGN HORI]ONTAL WIDTH OF SI
DITENSIoN FRou cR\Dr ro Borrolr or srcx 5'THICIi\.ESS OR DEPTH OF SIGN 3 ,
DOES 516I PROJECT EEyOr-o pROpERTy LINE VeS )l NO IF YES, DI}IENSION BEYOND PROPERfi LINE
iT:OTE: IF PROJECTIO.\. IS I.iORE, TII)"\ I2'. OVER, PUBLIC PROPERTY TTG SIGN ERECTOR I.iIJST FILE I{ITII THE BUILDI}IG DIVISION COPIES OF
HIS PUELIC LIABILITY E\D PROPERTY DAIL,\GE INSUR.q"\CE POLICIES.
rILL SICN HAVE ELECTRICAL I{IRING?
DESC.D.IBE TYPE OF }T.ITERITLS S16}I IS
_ves ( No IF yES, wHIcH Apply? _ELECTRTc{L sI6N _rLLUrirrNATED (INDIRECTLy LIGHTED)
CO}IST9.UCTED Dc -'htaol
SITE INFOR\IATION (L.l"\O USE IF YACA.'ITI :--- .-
PROPOSED USE OF BUILOI}IG OR LTIiD
CHECK ONE IF APPLICABLE
EXISTII;G SIGIIS (SiCN CODE): ARE TIIERE E.XISTING SIGNS? L YES _No
: 2ltxocon BUSINESS _o[rrDooR ]|ERCHi"\DISING
IFYES,DESCRTBEALLE-XISTING.SIGNS..FoRpqS.{,-\Ef,,,,,,,,,,,,,,,,S,
FIRY, ETC.e
ALL EXISTING SIGNS ON pREl'rSES(SA,\rE TAX LOT), fi- /z O lr'-e-
I HAVE CAREFULLY EX,L\IINED the coropleced application for pernit and do hereby certify that all inforoation hereon is true andcorrect, aad I further certify that all work perforned shall be done in accordance with the Springfield Sign- Ordinance, the
Uni.form Sign Code as adopted by the City of Spri.ngfield and all other Ordinances of the City of Springfield and the laws ofthe State of Oregon pertaining to the work described herein. . I further certify that ny Sign Contractors License uith theCity of Springfield is in full force and effect as requiredall required sign inspections listed on the approved pernit.
by Springfierd City Codes 8-2-6(J) and 9-7-2aL2\. I vill request
LISE ON
NA.IIE (PLEASE PRI}IT)SI6NA
SIGN DISTRICT.:ONE DISTRICT TOTAL SQUARE fOOTAGE OF SIGN
INSPECTIONS REQUIREDT SITE/LOCATION FOOTING OR T{ETIIOD OF ATT.,1C}I.\fENT ELECTRICAL
CpHT,t
FEES
TMAL FEE FOR PERUIT {5,oo
STATE SURCH.{RGE
(--
AL
DATE
OTHER
SIGN PERIIIT
CIIARGES:fld oe ELECTRICAL PER.TIIT:
CHARGES
/
,x
PROVIDE UL N1J}I8ER IF APPLICABLE
-*-
VALUE OF SIGN 4OI
P ',,,\LID,,\TIO:I
l) Seper:te Siqn Aoclicetion: A separaEe applicetion is required for each
separ3re irgn rs detrneq rri the Sign Code.
2) Electrical: Any pernit issued under this applicarion will include wir-
ing tn or on sign structure, the supply wires for conneclion must be
covered on tn electrical pernrit. Electricel connection must be madeonly by a State Licenscd Elecrricet Conrractor. Illuninated signs (both
incern:rlly and externally) must conforru ro Sections 9-7-1 (4)0(5) and
9-7-tS of rhe Springfield Sign Ordinance.
3) Plans Reouired: This epplication is to be submitted with two conpletese!s or plans drern to scale, showing dimensions and height of sign; ad-vertising nessrge on sig].l; location of sign on property with dimensionsto property lines, structual details of support franing, bracing and
foocings; neterials of constn:ction for si.gn and sign structure; el.ec-tricsl equipnent rnd lighting; size and loiation of existing signs on
propert), for the sane business, all as required to determine compliancer{ith the Springt'icld Sign Ordinance (Arti.cle 7 of the.springfield Ciry
Code). Also, show the following infornation on the plot p.lan (plan
shouing property lines and location of signs):
a) Shou the locarion of al1 eristing sign(s) as well. as proposed sign(s).
b) Shou the length of the street frontage taken up by the business or
bu i lJing.
c) Shov the locetion of entrances open to the public and driveways.
4) lthen required, because of design, size, etc., engineeted drawings and
calcul:rtons nust be prepared by a licensed engineer or shall contlorm.to design standards on file at the Building Division Office.
S) 'Plans of insufficienc clarit), or detail. will be rerurned to the ap-plicenr yich no pernlE being issued.
6) Signs nust meet corner vision clearance requirenents as described inFig. 9 of the Springfield Conprehensive Zoning Code.
7) i;OTE: No sign nay be erected which is less than 12 feet hori:ontallyor vertictlly fron overhead electrical conductors in excess of 750
voltsi or less thsn 5 feet in any.direction froD overhead electrical
lines vhich are energized'at less than 7SO volts. '
8) If e si;n is nor inst:lled r,.ithin 60 days afrer the date of issue ofthis pernir. the pemit shall be void.
s)Inso tions
a) Site Insoection - to be made before the s ign is placed. Usually,
-the foo.rnq lnspection (if applicable) may be nade at the sanetinc f,s che Srre lnspeccion. The Footi.ng Inspecti.on is to be
oadc after hole(s) is excavated, but prior to the placenent of
conc ret e.
b)Finel Ins Dect ion -to be made upon completion of all. work.
CLERK
DATE
c) Electricrl - All electrical signs nust be inspect
cal hook up efter che sign is erected and before
Eurned on.
24 HOUB, INSPECTION LINE AT
it
:'
ed for electri.-
the sign is
ctLL FOR THE REQUIRED INSPECTIONS 0N THE
726-3769.
SPECIAL CONDITIO.\S TO BE SATISFIED BEFORE ERECTION OF SIGN
ADDITIONAL INFOR\IATION NEEDED BEFORE PERMIT IIAY BE ISSI.JED:
PLA,\S REVIEI{ED BY:DATE
It
\
CIT T CF SE'H,I}TGFIEI,D
SPRINGFI ELD. OREGON 97 477
ISFORVATt0N:7:6-5755 I.\-SPEC[ IO:i REQUESTS: 7:6- j:o9
CITY OF SPRI},16FIELD
SICS CONSTRUCTIO}I .L\D ELECTRIC.\L IYSTALIJTION
c0lt8 INAT toN App L IcAT I0)l/ pE &\tIT
LOCATION 0F SIGr-(IOORESS
LEGAL DEscRrptrox E O 3 A-€
Oii}.ER OF PROPER,TYT
ADDRESS _
OIS(ER 0F SIC.\(IF CffiIER TtL{\ PROPERTY OIIINER)
AODRESS
oo
ON
-Nc
TAX LOT I
PHONE
PHONE
N&\tE OF 3USISESs. FIR1I, ETC.Dr r+*t oil > E tU7'dPNhq IIIESS
ALTSR
CTNIER
X IDE}iTITY
PROJECTING
INCIDE\TAL
DOUBLE FACE
NON- IDE)ITITY
SECOXDARY
SII(GLE FACE
}IULTI. FACE
X
RS. CO)JR,\CT3ES:
I{ALL
ROOF
IIARQUEE
OTHER
FREEST,\\DiNG
PROJECTING
READER BOARD
BI LLBO.{RD
srcN ERECrcax//d rr-tN 3 rtt s fit n < _pHoNE__.1{,1-/_26 q
A-DD.qEss-_xz'ry _
CI IY LICE.\SE IJTJ:.IB
ADDRESS
'oo
EXP
€c,o
?€ct =PHONE
PHONE
LICENSE NI'}IBER
DIrig\sIc:ls. t:.sT CI \\O CC.'JSTRUCTION INFOfu\t{TION
ToTAL HEICHT ABOVE 6R1DS !e I IERTIC.{L DI}ENSION OF SIGN RI]OXTAL I{IDTTI OF S
DIITENSIox FRoll cR\Dl: TO 8oTTO]I Or SICX 5'THICKNESS OR DEPTH OF SIGN
DoEs slcll PRo.TECT BEYosD PR0PERTY LINE _ YES X NO IF YES, DIITENSIoN BEyoND pRopERfi LINE_
.\OTE: IF PROJECTIO)i IS :.iOR.E, TIII\ I2'' OVER PUBLIC PROPERTY TTIE SIGN ERECTOR I;T,ST FILE IYITIT THE BUILDI}IG DIYISION COPIES oFHIS PUtsLIC LIABILITY T\O PROPERTY DA}[{GE INSURA.\CE POLICIES.
I{ILL SICN I{AVE ELECTRICAL I{IR,I;{G? _YES T NO IF YES, lllHICH APPLY? ELECTRIC\L SIGN ILLU}IINATED (INDIRECTLY LIGTITED)
DE5C9I8E TYPE OF Y.ITERI.\IJ St6}! IS CO}ISTP.UCTED OF CT L-
pRovIDE uL NUIBER IF AppLIcAELE
-€*
VALUE OF SIGN
SITE I}IFOR\IATION (L,L\D IJSE).-EXISTI.\G [,ISE OF 0R LA\D (0R I-qST USE IF vACA,lTi ,__-_
. l.O7't-t rt.,e!-!-
PROPOSED USE OF BUILDI.\G OR LA.I.{D:
r::i.[#^'',ii.^'*i,#:T::.::;:-:::#ff::.H[}':i:;ilu,,
FIRY, ETC.e
Al.L EXISTING SIGNS 0H PREUISES(S{UE TAX LoT):/"-\ /)
I tlAvE CAREFULLY EX,r.\IINED the coropleted application for peroit and do hereby certify that all infonaation hereon is true andcorrect, and I further certify that al1 uork perforred shall be done in accordance with the Springfield Sigtl Ordinance, the
Uniforn Sign Code as adopted by the City of Springfietd and all other Ordinances of the City of Springfield and the lans ofthe State of Oregon pertaining to the work described herein. . I further certify that toy Sign Contractors License rith theCity of Springfield is in full force and effect as requiredall required sign inspections listed on the approved pernit.
by Springfield City Codes 8-2-6(!) and 9-7-2OL2\. I vill request
FEES:
TMAL FEE FOR PEtrTtIT:{6,oa
STATE SURCHARGE:
(---
DATE
OTHER
NA},IE (PLEASE PRI}IT)
SIGN DISTRICT-loNE olsrRlcr 11 -TOTAL SQUAXE fOOTAGE OF SIGN
ELECTRICAL
SIGNATUR
a
INSPECTIoNS REqUIRED:SITE/ LOCATION
-FOOTING
OR TIETIIOD OF A'IT.1C}$[ENT
SI6N PER}IIT:
CTL\RGES:fl6 oC ELECTRICAL PEL\IIT
C}{ARGES:
/
./L-ERECT
RELOCATE
sIGN }|\\UFACTURER (IF OTITER TIL{\
noerss /S iC__LU<lt
EIJCTRIC.{L
/'no'
r,'.\ L t 0..\
l) leoere!r !j!n_llp!_Ilr!ien: A separate apPIicf,Eion ''- reouired for each
separule irgn rs derrnco iri the SiSn Code.
2) Electrica[: fury peraic issued under this appticat
ing rn or on sign struclure, the supply wires fot
covercd on an electrical pernit. Eleccricsl conn,
onlv by r State Licenscd Electrical Concractor.
intcrnllly and externelty) musc conform to Sectio
9-7-tS ot' chc Sgringiield Sign Ordinance.
3) Plens Reouired: This apptication is to be submi
secs o! plans drlun co scale, showing dimensions
verEising nessaqe on sign; location of sign on Ito property lines, structual decails of support
foocings; netcriels of constnrction for sign an
trical equiprent 3nd lighting; size and locatio
ProPert), for the sa"tre business, all as require<
nith the Springficld Sign Ordinance (Article 7
Code). Also, show rhe t'ollowing informacion o
shouing properry lines and locaiion of signs):
F SPRIN GF,E[ D
( ClIy O
6
".t",fi':i,:,l
Holl
'cl
, Oregon
I:?;,x;'*"(
flgt
B 56236
q 1(3 Z
a) Shov the locaci,on of all existing sign(s)
b) Shon the length of thb streel frontage ta
building.
c) Shov the loc.rtion of entrances open to tl
4) l{hen required, beceuse of design, size, etc.
calculrtions nusc be prepared by a licensed
.to desi3n srendards on iile 3t the Building
5) 'Pl:ns of insufficienr clarity or detail wil
PlicanE vith no PerniE being issued.
6) Signs nust mcet corner vision clearance re
Fig. 9 of the Springficld Conprehensive Zo
7) IiOTE: .r-o sign oay be crected which is ler
or verticelly fron overhead electrical co
volts, or lcss than 5 feet in any dirccti
lines vhich sre energized'at less than 75
?Nl
(
(
(
gt
(
i
I
l
A nl
9) Insoect ions:
a) Site Insoection - to be made before
t.he Foo: r::i InsDection (if app I icat
t inc,rs Ehc Srre lnspection.The I gct' alt(ror
oade aftcr hole(s) is excavated, b' prl
ConcteEe. +_
b) Finel Insocction - to be nrade upon conpletion o! ar^
c) Elcctricrl - All electrical signs nust be lnspected for electri-
cal hook up efter the sign is erected and before the sign is
tuflred on.
clLL FOR rHE REQUTRED rNsPECrr0NS-3I.X" 24 HouB: INSPECTToN LINE AT
(
ara"na oa ltaol !6!rr.a
SPECIAL CONDITIO.\S TO 8E SATISFIED BEFORE ERECTION OF SIGN:
S) If e si;n is nor inst:lled r,'ithin 60 day €.'this periir. thc pereit shall be void.
ADDITIOXAL INFOR\IATION NEEDED BEFORE PERMIT I.{AY BE ISSUED:
PLTuYS REVIEI{ED BY:
(.
(
(
\
((
\
I
:
iI
:
?
!
'"
ffiHFE Meffiruffi
fl\GYffiFE ru&YB A,L--
Jriiffi
.*aq.ii $u*i lL,,#urruffi SSELT R[A f4t\. *".J
.i ',+ '';
, /j ---
r!*.-- 4 ' '
". .",t t
4-/,
ri
^ ''']ftl t(i .": :
i_" ,r !"i6I ,
ttt r:-{tttrt;'
;({
a
i
i
II
)
i
i
:
!
!
t
t
tI
;
.f r cli al" t t' ! ';:{zs
l:4{;/il{'*'/-wN ii{
€Ntycf:':'.$ FffiN tii-
8,,4gY,;E74ff€ i"
,4q5iF.r4 gLY ltS'"'$'*
tk,+,?"
*i''
a.
.*
ia#r+ 'n'
,*--r:'6' .-'-* '--<J&;a--'-
- r" i&'l ii#dr:i-!s -*' ' r:i€'r'{q .lll'* '#- -'d#tn Ep i#"}'
{
t
t';il
ll,lr
I l .-
t
1r
ri illl,i
ti
:l
,l
il
t
I
APPROVED .r'
-'-.--.'.;"..4,!----L-nF
ll
--..- '- - r-:-
.-*'7;*'"
ili:li
I
19
i
t!
Ir
i
at!
?
:
ii
!
i, -t-a
il
t'
I
I
t
I
(@rl '. It i
t.
1:il
I
GI Tr MlU\ici
r Nrr€R $-r ,tTt IiN ,&t-
! lfl,t ,P..i I q Jl
I {
@ {-r"5"'-
-__i|
t
i
t
It
I
Il,
it
Sldned
,.-'- -.--"&l^-''"F
t-:
L*l tl"t r'tf J \ tfi-,
-l
'ai
I
I
t
:!
I
i
!
l
1
!- ; . :'.
:J
, fi ! , '. -.'. *r ''-.1 i':"49i"' '
*ir... ^a- * . a-:1, *79 fj_
a"
{{'"'*',s $:l: *l "'i -'; * i? r\ 41i'/if ; ;t'!:+r i-
1 I' i i;'i,-* L"i ;* {r" * 1'J't4f'"'
,, :,, { . r-.- ; 1'/;;' .' /!-;t*,i'.,i',' i;s ; ;':
:, ! ,11 tu i-^''
g4t";,. €tf-',. 1g 41*', Et*:'* :":/; i
-*l#siitB$)
'il.*i?i...
;i!irt
i, l. ;, r, i ,l
' ir I t, ll I :
'l ll
I
t
i!
I
I
i r'.
t
!r a.r!
APPROVED L4-3 p €/.^
Signed
t t:
I
h
!I!
i1
{
.t
:tli
!
"a
it
tltl$!t,!.:i
tl
;lli
;:
C i I" rdrii F,.ji:
ftJ 1- =
F. I ;',\T r;F\i '\ -
- *r1; :.'. :'-t1'{ '&.at. s:r*
i
I
t:
i
I
t
I
I
!
;l
I
i
I
- tl, i.
I:l
rt
*
I*
ri,
t;"
I
t,
I
E
I ...-i-
a'
a