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i- <br />C 1212-17Dj <br />FOR OFFICE <br />USE ONLY <br />BUILDING <br />ZONING <br />Bld .Rf' Si-a <br />Lt U <br />Lot Area <br />Garage Size <br />Front Setback <br />VALUATION <br />Rear Setback <br />No. of Stories <br />I <br />Side Setback <br />Occupancy Group <br />( - <br />Vacant Site <br />Yes No <br />Occupant Load <br />Use Zone <br />•Basement <br />Yes No Nl� <br />Height Limitation <br />Type of Construction <br />/ , I{ <br />No. of Dwelling Units <br />�e <br />Fire Sprink Reqd <br />/U2 <br />Landscape I Planning Inspection <br />Reason <br />needed before fi al? Yes No <br />Fire Alarm Reqd <br />�N <br />Approved b � Date � <br />Reason - � <br />cm e <br />Comments: <br />dff5vre(KW6'.55) <br />/eu0 0 <br />Approved by <br />Dale -/4 - <br />Comi�,: nW: <br />FEES <br />Plan Check Fee <br />Building Permit <br />Surcharge <br />Additional Plan Check <br />Water <br />Sewer <br />Systems Development <br />Public Works <br />Traffic Mitigation <br />Other <br />