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<br /> • C6nCi OP! LIS? !OR ISSOlU1C8 O! PEWLI?8
<br /> POR OPPICE USE OKLY
<br /> ADDR888 OR L�G�1L DESCR I P?I O*s �4� �'j,�,,��,� �j� ,
<br /> 1'YPS OP MORR s �{s��_ .— --
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<br /> ZOMING jtEVIBN HYs n�:B �pRavaa:_ S—(�—g�y
<br /> Zoninq District s �.�" � �i` Lot 11rsa: Q�� �L
<br /> F i re Dept. s h 'L . Nidth: l � �- �
<br /> _`�___._ �= Yo +-
<br /> Paat Ottics: � , � . Propos�d B�tbaaks:
<br /> PZot1t sr�n r,►,C, R.81Q�_ �•_
<br /> Zoninq Pil�:i ^ Rear:,1� L.Sid�s����`.__
<br /> Counci 1 l►pproval Date s —" J1d jawat Stsnatur��: ..—...
<br /> Aesolution 1: � Lak�= ,••�' M�tlan�� ,�
<br /> Hardcover: Exiatiag�: �O�o : pro '_ � `�
<br /> ----------- �..a�: /1 %
<br /> �,—
<br /> Gradings Statf Approval Dates NO N�" Council 1�ppraval D�to: "�
<br /> Septic s Staff Approval Date:� Bli: /�
<br /> BOZLDIIiG REVIEN Bl[ DAT6 11PI�'R�s S •�!- ��
<br /> .
<br /> OBCs �S CO�$TROC?IO/ TiPBs 1_.
<br /> BLDG SIZB: H. L. W,
<br /> S1UC CHA1tG8 �iBfQOI�s Yes No '�'—
<br /> Sq. Pootage: Esti�ated Gonstructiaa Valus� I, O o o �—"
<br /> 1 st Floor x � �--�--�--
<br /> 2nd Floor X ,�
<br /> x � '_"
<br /> x •
<br /> Garage X s
<br /> TOTAL x :
<br /> Insp�ctioas itequir�ds Mort i�quirinq Separst� Psr�its:
<br /> Site Plumbing Gradi�q/lillinq
<br /> �,r,c Footing Mechanical Pire
<br /> Praming well Water Conn�ction
<br /> Insulation Septic Sewer Con:uctioa
<br /> Wall Board Pireplace Other
<br /> �Pinal �
<br /> Pireplace
<br /> REVIEi/ DY O'lH�tB: OJ1SEs �
<br /> Accessz Exist nq. b�
<br /> Access Approvals Date � By:
<br /> Aa171WC8 TO BE ti0?1RD � PE�lIITt '
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