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FOR OFFICE USE ONLY Q / 3O <br />BUILDING <br />Bldg R.I. Sae <br />Garage Size �Ov ° <br />jf. l27 <br />VALUATION <br />Z <br />No. of Stones <br />Occupancy Group <br />N <br />Occupant Load <br />Basement <br />Yes <br />No <br />Type of Construction <br />Q <br />Fire S nnk Re d <br />Reason <br />Fire Alarm Recid <br />Reason <br />CO Required? <br />Enclosure JRCW&4 55 <br />Approved by <br />Dale <br />Comments zo/2 rQC <br />FEES <br />±ck Fee <br />Permit <br />Sewer <br />Public Works <br />Traffic Mitioat <br />ZONING <br />Lot Area <br />Front Setback <br />Rear Setback <br />Side Setback <br />Vacant Site <br />Yes No <br />Use Zone <br />Height Limitation <br />No. of Dwelling Units <br />Landscape I Planning Inspection <br />needed bef f Of z4Z_ No <br />rove b t <br />Comments <br />