23D-148 (3) �-- y r
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IDate File No. �(
` �Y • Mil G PERMIT APPLICATION �/�/��
Zo , in• Ordinance Section 10.2
DEPT OF BUILDING IN • Oa 1. _ .ap. .iat„ .u;...: :!,,. • A Oj j,J/L/V /6 gq(20 ALCe'('":...
Address: /// A//i/c K cT /,.!r .7,liu/f`-1/zr7( Telephone: ,,--4(, 5T I Cc'
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2 . Owner of Property: l(4-1,u/i/z // /f7/r-)/r) Z(64-'
Address: /// //t/7C/e7 5/ .5/ ,//Cy-7L1,%Q6,4/'/c 1 Telephone: -,cr(, - .S-S`/-
3 . Status of Applicant: 1 Owner Contract Purchaser
Lessee Other (explain: )
0 4 . Parcel Identification: Zoning Map Sheet#; i ® Parcel# ILj ,
Zoning District(s) U Y•V_ )
Street Address \ 1..-\ t \il,0 ,‘, ( s ,j - ,(-
Cl-
5. Compliance with Zoning: Existing Proposed
Use of Structure/Property
Size of Structure (sq. ft. )
Building height
Building Coverage
= Setbacks - front
- side
- rear
CD Lot Size
Frontage
0 Floor Area Ratio
% Open Space
= Parking Spaces
Loading Spaces
Signs
Fill (volume & location)
I
6 . Narrative Description of Proposed Work/Project: (Use
0 additional sheets if necessary) (,•I , qn '` ) n,\ 3-0 ,v1:, 0- •
(\ (' V1 l P li ,, 1 t l 1 1n A t t (� lla1Y. -; , two, ljsi vv0
7 . Attached Plans: Sketch Plan Site Plan Y-01 -
8 . Certification: I hereby certify that the information contained
herein is true and accurate to the best of my knowled e.
Date s`./2/9 0 Applicant's Signature: 7,l��liJ? /� ` z'�;
THIS SECTION FOR OFFICIAL USE ONLY:
XApproved as presented
Denied as presented
Reason for Denial:
J
Signature of Building Inspector7. =L ' I% z-c.1 Date "
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