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� � <br /> FUR OFFICE USE �IVLY C��� �� �`� J <br /> � BUILDING ~ PLANNING��— <br /> �Id9(fi/Addn/Rem Size 2/��J S . Zoning Classificalion i� <br /> Garage Size s , Overlay/Agreemenl � <br /> VALUATION Z Z 3 /(o Non�esidential Use <br /> No.of Slories Z Proposed No.of�vielling Unils: <br /> Occupancy Group 2 !,( Tolal No.of Dwellinc� Unils: <br /> Occupanl Load Landscape or Planning Inspection <br /> Easement Yes_ No�in�Unf _ needed before final7 Yes_ No_ <br /> Type of Conslruclion Planning !nspectar. <br /> Exsl9 Sprinkler Syslem7 Yes No__Unk_ �hone#: <br /> Fire Sprink Reyd7 Ye: _ No___ Approv Date: Z / <br /> Reason Historic Appr ved 6y Date: <br /> Exslg Fire Alarm? Yes__ No___Unk School Miligation fteqd? Yes_ Mo <br /> Fire Alarm Reyd? Yes No Commenis: <br /> Reason <br /> CO ftequired? Yes No <br /> Enciosure(RC�NG4.55) Yes_ No <br /> �pproved bv: Date: /2 / <br /> Comments: �i �y //LG � (.�/1FG <br /> i <br /> FEES <br /> Plan Check Fee <br /> [3uildinq Permil <br /> Surchar9e <br /> Addilional Plan Check <br /> Waler <br /> Seeier <br /> Syslems Oev. Uue7 Yes___ P�o <br /> Pu61ic Works � <br /> 1'raffic Mitigatian Due7 Yes� No Rcpt IP <br /> ScL�ol Miti9alion Paid? Yes Ne__ Dalr.Pd <br /> 7 — <br /> � / _. <br /> v <br />