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C �� ` <br /> o..cdpdon or worlc eoMinwd: <br /> �,p2� <br /> �� <br /> FOR OFFICE USE ONLY <br /> BUILDING ZONING <br /> VALUATION �ot Area <br /> BI .I. Size � �o Front Sep�adc <br /> Gare Size Rear Sefbeck <br /> No.of Stories Z Side Setbeck <br /> Basement Yes No V Vacant SNe Yes No <br /> T of Construciton � — 13 Hei M LimNatlon <br /> Ocw n Grou U68 Z�^° <br /> Oxu nt Loet No.oi Dwelli Units <br /> Firo S nkbr R 'd '� b Date <br /> Reaeon Comments: <br /> Firo Alartn R 'd S <br /> Reaeon �1� <br /> roved b _ /` Date - � � <br /> Comment <br /> FEES <br /> Plan Chedc Fee <br /> Buildin Pertnk <br /> Surcha <br /> Additional Plan Check <br /> Water <br /> Sewer <br /> S . Deve t <br /> Public Works <br /> halfic Mit' ation <br /> Other <br /> 2la <br />