Laserfiche WebLink
� ' �CT-TECK ��'F ifIST FOR ISSUANCE OF' �E��IITS <br /> FOR OFFICE USE ONLY� . <br /> ADDJ�ESS OR LEGAL: ��7f� C�� f��� C`,���P r� �`"' A � <br /> PID: <br /> �ES CRIP'I�ION OF W ORK.: �-'c�1 Z �� � � `S � I �- �oa( 1r1cc.�;sC� <br /> (�- ---------------- <br /> -----------------------��---------- <br /> ----``--- -- O 'Z 3 01 <br /> ZOY�G REVIE�V BY: ----- Qir1" ^-- pATE APP�OVED: <br /> �UTLDING REVIE�V BY� �.,���.�. � . . DA.T`EAPrROVED: �c��zy-o� <br /> � � �T--- ---=------------------------------- <br /> �'EES TO BE CHASGEA: Misc. Fees Calculated By: <br /> PER�.�LIT Yes � No SE�YER COi�INECTION <br /> PLAN REVIEti�T � Yes �/ No tiVATE.RCONNEC'I`ION <br /> STATE SURCHAR.GE Yes — r/� �o <br /> INVESTIGATION FEE Yes No r/� PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> -------------------------------------- <br /> ----------------------------- <br /> �OY't��tG� �CTi-�CK LIST Zoaing Districr, � �cxl Utc�s� �--�o�� . <br /> Fire Departmenr. Post.Office: School District: � <br /> L,o� t�rea; Sq.ft. Acres �� Widch Depth <br /> Survey Submitted: Y�s _]� ttlo Date of Survey: �U � v <br /> po�l r'or�� 1'�, � Poc,{ \OC��hw>� . <br /> Proposed Setbacks': �Q � • : <br /> Froat G�: Y�Pr Yl � Side: 1 . <br /> w�s� -��,� 130' <br /> P.ear(�t)� ��'�2- L•eft�Slde: <br /> ` ('o ! �r�l 1-(Sv <br /> ' `q T'o btw:r� 3c�� ZVPr�a�d: �Ac <br /> .���I.��A4�Cr roni C,�.,r„r-- 3U <br /> •-�Po�_ ' "���...,. . <br /> pa�r Na� f�� ; „ ��_ <br /> Buil�in� Height: DeE. H�t, �� ��j f Peal:Ho�• <br /> Lot Covera�e: �'1�___ <br /> Gradin�: Scaff Approval Date: U « By:'p.A,�+we�S�o�cii_ Approval Date: ' <br /> Sep[ic: S�aff Aporov� Date: !�J F ' __ �Y� �� <br /> 7oain� Flle: � Resolutioa: R R?solution Da:e: <br /> Shorziznd Distric�: 1/ <br /> � �!�E,SetSack: h /�i L.o:Cove2�e: <br /> Av�. Setbac�:: G'1� <br /> � Proposed <br /> �.�scieo �,, <br /> H�ecover: -7�' v�! �3. `-J`yo �Co���cJ <br /> 7 2" ' (�}- <br /> Z- "�.�.; <br /> i <br /> ��0-? `C!J' <br /> . ,,_,. _,. <br /> -a e�-a::e�: `iz� `�� �'=-- ��: �.�;�__.. .��_-� — <br /> �-?a�eco�:e- �r'z:_... _� � . - - <br /> ���L�:�� rLn ho��e): <br /> � . <br />