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Date L �` <br />P?,r,2T]iF:G DE?AP.T:dF'..::T PFV?E:J <br />Plan Check No.: �� I � �Q��� _ __ <br />SEPA No. <br />Owner: <br />Address (if known) : —I�y✓ � �`"�Q �i� �r. <br />2oning: _� <br />Lot Area: a � / �-'��'� <br />Height Limitation:,�.� <br />Use of Building• C���� - <br />Special Considerations <br />COAL"SENTS: . . Date of wmment <br />� .. ._ , '�r'.�_ , _ . . „� �. . <br />_ . � .. , � ' ��� -� � � �, <br />APPROVED: <br />Sicnature <br />Date <br />