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i•iii �r G'If.ItCll <br />PUBLIC WORKS DEPARTT•iF.WT <br />BUIL�It�G UIVISTON <br />Applicant: <br />Address: <br />Praject Name: <br />Project Addres <br />At this time, your <br />accepted for filing, <br />r�hether any additional <br />P�OTICE OF CO�dGITIONAL .4CCEP7AP�CE FOR <br />PILING OF BUI!_�ING PERMIT APPI.ICATICN <br />_ l� 2 � ir,� l� 5 / ---�--�- , _.. . . _._ - <br />, �-r-� �n., iJ>� „�� ; %i7,�, � :;: ; � � :, <br />_ l�?S�fi l3�%''Pl 5F �ioi���� ��=1- �8o�v <br />building permit application is being conditionally <br />pending the determination of its completeness and <br />land use approval(s) includiny but not limited to: <br />Zoning Code <br />State Environmental Policy Act <br />Shoreline Nanagement Act <br />is required in order to complete your applicatiun. <br />If the City review determines that any additional land use approval or any <br />additional information is required to complete your huilding permit <br />application, it will be necessary to submit this additional information or <br />acquire the additional land usE approval prior to your apptication being <br />considered complete for filing. If no other land use approval or additional <br />information is required, your building permit application will be considered <br />filed as of this date. <br />Fees charged or refunded will be in accordance with Section 304(c)(f) of the <br />Uniform Building Code. <br />4a1id only when sig ed by both parties: <br />���� . <br />r <br />cR��' ti�- �7' �C� <br />pp icant or �u orize gent ate <br />� Y � verntt nta e ec m cian <br />(445G) <br />