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� <br />FOR OFFICE USE ONLY <br />BUILDING <br />61dmTllAddriRem 5�;-c �.�/� �`� <br />Garage Size -- <br />VALUATION <br />No ot Stor:es O� �' b`� <br />Oaupancy Group '�J <br />Occupanl Load �� <br />Basement Ycs � No <br />- il� / <br />F. <br />Fuc Sprink Reqd� <br />Rcascn <br />Gxstq Fire Alarm� <br />Fire Alarm Reqd? <br />Rea,on <br />CO Required? <br />Yes No U <br />Ycs NoZi <br />Yes <br />Yesa No <br />Datr <br />C G� U �«M+. �' <br />� <br />-7--10��� <br />f� WI �l 0�{�Oo� <br />PLANNING <br />Zoning Class�Gcal�cn ' <br />OverlaylAyree•nent <br />Nonresitlenlial Use' � ,' <br />Proposed No o( D�veliiny Units � <br />1-otal No ot Dwclliny Units. <br />Landscape or Planning Inspection <br />needed before final? Yes No <br />Planning Inspector. <br />PhonetJ. •' ' . +� <br />ilpproved by: Date: <br />Historic Approved by: . � Da�e�. <br />School Mltigation Reqd� Yes No <br />Commenls�. <br />z�z <br />