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Date Filed File No. OO19J1
ZONING PERMIT APPLICATION (510 . 2)
1. Name of Applicant: CPLLMYOA S*VJ Co
Address:_ �Y7 U1.AO1J ST . Telephone:
P1�E1a) 1 O\z0�
2 . Owner of Property: . 5
Address : - x3S Mawirw]C sr Telephone:
0.9X2FJ_CE 1 r_%A
Status of Applicant: Owner Contract Purchaser
_Lessee Other (explain: 311 MOAr140lJQFQ-f rj-&&M
*ion: Zoning Map Sheet# oZ?19" Parcelt# ��'�,
-rude overlays)
h
Required
Exieti Pro sed b Zonin
ty ec
.erior work, skip to '6)
print) /
it
e L: R:
e
area minus
:ing)
Loading 1
Signs
Fill (volume & location)
6. Narrative Description of Proposed Work/Project: (Use additional sheets
if necessary) 1►*'r0%i.. ( 1I 11um.1Petsi=0
Q2A]AID $]6U . CIAITEf2A1�1 11U�u/dl'Irdy1 PFQ
- Fwr
7. Attached Plans: _Sketch Plan Site Plan
8 . Certification: I hereby certify that the information contained herein
is true and accurate to the best of my knowledge.
Date: /8/413 Applicant's Signature: _
THIS SECTION FOR OFFICIAL USE ONLY: LR�� �
Zoved as presented/based on information presented
Denied as presented--Reason:
S ecial' Permit and/or Site Plan Required:
nd g Re re Variance Requ
S natur Bu Spector �V�3 Date/
NOTE: Issuance of a zoning permit does not relieve an applicant's burden to comply wdh all zoning requirements and obtain all required peranNs
from the Board of Haalth,Censorvation Commission,Doporonont of Publio Worts.and otberopplicablo pormN granting oulhodllos.
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