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( <br /> FOR OFFICE USE ONLY <br /> ��-ag-flb <br /> PERMIT NUMBER CGG ([—C�Q I SUB-PERMITS <br /> SITE ADDRESS 3�� �'�'�`A'�"�' � <br /> ZONING <br /> LOT A EA FRONT SETBAC�K REAR SET�A�K SIDE SETBAGK VACANT SIT USE ZONE HEIGHT LIt�11TATION <br /> � \ / YES N � 1 � � <br /> `J <br /> NO.OF ELLING APPR VED 8Y DATE � COMMENTS <br /> UNITS • ( � <br /> C- �Y/ <br /> BUILDING <br /> BLDG/T.I.SIZE GARAGE SIZE NO.OF OCCUPANCY OCCUPANT BASEMENT TYPE OF CONSTRUCTION <br /> STORIES GROUP_ LOAD YES NO <br /> � Sr <br /> �� <br /> NEW FIRE SPRINKLER REASON NEW FIRE ALARM REASON <br /> REQ'D REQ'D <br /> APPROVEDBY DATE COMMENTS z�Q3 �2C. � IA�SI//�t+cC- <br /> �z�� � oo c�s�� <br /> r ; .-q, 2/ <br /> VALUATION �� �J� PLAN CHECK FEE <br /> FEES <br /> BUIL�ING WATER <br /> SURCHARGE SEWER <br /> ADD PLAN CHK SYS.DEV. <br /> PLU�dBING TRAFFIC MIT. <br /> MECHANICAL OTHER <br /> SPRINKLE <br /> PUBLIC WORKS <br /> TOTAL TOTAL <br /> a�� <br /> O• S <br />