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�;by Q� "ti,�,t�Q�"�� PC ExhibitE
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<br /> �����'A1 Pro�erty Address: 2 �o S a� n EKl sF[IUG
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<br /> �:-r Pre�arerl b��. �, ,a r t�:,s Date: /z.
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<br /> Stormw�ter Qu�liiy C}verlay Drstrict Tier: (Circle one) �ier�� ier� 7ier 3 TYe��4 :ier S
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<br /> fn the follo�r�ng ta��e identity �I{ it�rns af existing h�rdc�ver on the proper�y, keyed by Iett�sr fo Certificate ofi
<br /> S�rvey (survey must accompany this fivrm). Use as man�r lines �s necessary to acct►rately depict existir�g
<br /> har�ca�e� status of the property, For Tisr 1 properties, iderttify any feat�nes by I�tter�lvf�ic�t are split at #�re
<br /> 75' s�tbac+�line and �alculat� f�ardco�er square footage se�,�r�tety.f��.eaeh portion.
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<br /> _._...� rPrc��ed Harccov�r�ext pagel
<br /> �tECEIV�L�
<br /> 7'f;�$rs a�infa:nat�on pa,:.��t regen7ing Harcrcovsr. Ev�y e!`�ori nas beer+me�de�o insure the accucac�a!the�n�rmah�t,aontar� n�ir� 9r1�I
<br /> haaievf;,i!any Infarma�:on is not cons stent w;Hs prov,s.m»a af tfi+s C:.y Code,the Codd nru�ri.ions�-�11 preval,. UC� I J Lu 1�
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<br /> � � � �� CITY OF ORON�
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