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Date 4 - 2� - d'T <br /> P:.:+tiNZNG DE2nRi:1E!7T Ps'VZEt4 <br /> Plan Ch=ck No. : _.- b 7 / � �� S G <br /> SEPA No. � <br /> Owner: �.(�, � v0 � Gfaa lH � <br /> Address (if known) : .3 �,� �o /7 ! (���l�`_� <br /> Zoning: <br /> Lot Area• <br /> Height Limitation: <br /> vse of suilding• S �Zmna SI'� P �l <br /> Special Consi.derations•� <br /> CO[2*SENTS: Date of comment � <br /> �_< ✓ �E��itiXs f�i9/dk�rNG �4u i�{/l�t%iU� �z <br /> 7?e..�-..al� c�.� � 9/87 <br /> � <br /> �� .f�'�Gv�i..`� <br /> ,.D�fi-�v�n� G2�i�� ,.(�-� .u�V��nJ �/,^�,�K.,l.,��u-� , <br /> /Ca �� c� ..l�c. ��aiz/�G><� <br /> '� y / <br /> APPROVED: <br /> �_ J i�,�jy, <br /> n, .� � �, i � <br /> ✓ —.- �' , <br /> Si,rnature � Date <br />