30A-032 (48) i S
Date Filed /� G
G� /// File No.
:' ZONING PERMIT APPLICATION (§10.2)
1. Name of Applicant: -7; Z 6
Address: pjp Telephone: Sys=.Ss'a
2 . Owner of Property: �„�Q��,, 145-s-c��-,•J
Address: 2 /* ;v 5r I Telephone: py-
3 . Status of Applicant: Owner Contract Purchaser
Lessee Other (explain: A )
4 . Parcel Identification: Zoning Map Sheet#OWNIA Parcel# U-,
Zoning District(s) (include overlays)
Street Address
Required
5. Existing Pro osed by Zonin
Use of Structure/Property __
(if project is only interior work, skip to #6)
Building height
%B1dg.Coverage (Footprint)
Setbacks - front
- side
- rear
Lot size
Frontage
Floor Area Ratio
%open Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume & location)
6 - Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary)
7. Attached Plans.
/� Clrctrh Ulan Site Plan
8. Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowle gel
Date: Applicant's Signature
— — — — — — — — — —
THIS SECTION FOR OFFICIAL SE ONLY:
Approved as presented/based on information presented (l *ewh 67.
Denied as presented U
Reason for Deni 1:
Sign e o ilding Ins or Date
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