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FLr.S::I.`]G ' ?.SF'�.:::1'= R=`i'r•. <br /> Plan Check No. : ' • �� /�7�� � <br /> SEPA No. : ___ <br /> Owner: J(l�UG �/Yh['L�.Pit�t� <br /> Addzess (if knewn) : a �3 2 �(,LG�G�vl�2� <br /> �c��— /� Z l3u�� 3z 1'�/�' � �'n�-w�of <br /> Zoning: �,-7i <br /> ���/'i5�'r/!�l � <br /> Lot Area: <br /> Height Lim:tation: 3�/ <br /> tJse of Building: �r <br /> Special Considezations: <br /> COMN.E�TS: Dat�� of ccr.i.;,ent <br /> J`i f� �Q.e� �L�� {a � `o,l cc.�� c�—�j-�b <br /> �i��� I'-•LfLv�/n� C/—/O�b'/ <br /> �� c''�t'�' ,���IC!,�v ��i,1�1' CGL �"t. ( ��'%���'; <br /> . , <br /> nPPROVED: <br /> qp�,ro,:.d as to cemplianCe �:ilh <br /> zanir;;� f:1=.PA :�nJ �:isu�iioc.:�7 ;r.rmit <br /> rcyuiruncr,ts. <br /> eY -�- r-'-- o��=—�=�Z-4�;�j <br /> n 1 <br /> Signature Date <br />