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. , i <br /> t=OR OFFICE USE ONLY <br /> �p`IL/`�f� <br /> PERMIT NUMBER � �(�� SUB-PERti11TS <br /> _�\.� <br /> SITE ADDRESS <br /> 4 ?ssf4lo - 4�rff ,5�- 5� <br /> ZONING <br /> LOT AREA FRONT SETBACK REAR SETBACK SIDE SETBACK �A�ES NOTE UnE ZnNE HE�;LIMITATION <br /> G �I � S ' '� " <br /> Il0� `pr'J (J'� � � [SLOfa2 <br /> NO.OFDWELLING APPROVEDBY DATE COMMENTS (yj� N WC/1'a=(a �' N� <br /> UNITS �L P!1"SP�7 /S�1 4+t� •:+,no. fU"z..v�rriXcS �'l�l+�✓�✓,hlr <br /> L S � <br /> t3i,�-��1�'L- �f�S�7z LIeJ`J <br /> BUILDING <br /> i BLDG/T.I.SIZE GARAGE SIZE NO.OF IX:CUPh'N)Cv OCCI�°AM BASEMENT IYPE UF CONSTRUCTION <br /> STORIES GROUI' r �1��•� LQ� YES NO U � <br /> �'f��� � yWL� .�- SCn,J��_ <br /> I NEW FIRE SpRINKLER REASON NEW FIRE AU RM REASON /+ <br /> RE�'D , 1 L' 1 � t� �. <br /> REQ'D I�IA N 1 UI� �i "\�= � � ' _ .' . <br /> � � U�(, � 5 ��pc��cFl�LE �c;Dr . . <br /> ENCLOSURE APPROVED BY/ DATE COMMENTS ` 1�`n . -��� j�y ��L h,U^ � I <br /> �{ES ,��la t� / >�,� N��c.� � r�� �r� b_ y � _ p" , <br /> VALUATION // 7 — PLAN CHECK FE�' 72 �3/ - 5"�Z 9�(���� <br /> FEES <br /> BUILDING __ / ��'"' �� WATER <br /> SURCHARGE `Y S� SEWER <br /> � <br /> �� SYS.DEV. <br /> ADD PIl.N CHK � <br /> TRAFFIC MIT. — <br /> PLUMBING <br /> MECHANICAL OTHER <br /> SPRINKLE <br /> PUBLIC WORKS <br /> TOTAL TOTAL <br /> �/� <br /> �— -- <br /> '�fiti`�T�� � it�:�i <br /> _ . _.. ! S H;--9♦ <br />