11A-058 (13) 323da-
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f t
004202
Date Filed _ File No.
ZONING PERMIT APPLICATION
( I�
Name of Applicant:
v/ Address: Telephone: �n,6_
l Downer of Property: 2CCe- Vt'\'SS�V� ` � 9490
Address.. "b m Telephone: ,�q6-y475'
Status 'of Applicant: owner contract Purchaser "
(J _Lessee Other (explain: ) "
4 . Parcel Identification: Zoning Map Sheet¢_ I( A- Parcel$_Ilse
Zoning District(s) (include ove lays) UA_U
street Address
Required
5. Existinq Pronosed by Zoning
Use of structure Pro erty J.
(xf pro7ea is only' in error work, skip to N6)
S 'lding height
&Bldg. Coverage (Footprint)
=ze
ks - front O'
- side L: R: L: R:
- rear IUya oco '�p
Frontadjl.
Floor Area Ratio
" sopen Space (Lot area minus
building and parking)
Parking Spaces
Loading
Signs
Fill (volume e location)
J 6. Narrative.Description of Proposed Work/Project: (Use additional sheets
Vif necessary) /�' x . (r�' Rood' arm. C'or tae AccrcS
7. Attached Plans: Sketch Plan site Plan
. S. Certification: I hereby certify that the inf99rniatcontaine herein
is true and "accurate to the best of my knowledge: ,
- - - - - -C- - -' - - /- - -Date; 9 5' Applicant's Signatur
THIS SBCTION FOR OFFICIAL Us NLY:
Approved as presented/based on information presented
-;;;, enied as presented--Reason:
Special Permit and/or Site Plan Required:
Finding Re ;uired: y, ; -/ p Variance Required:
Signatllrerlof Suildin pector 'mate
NOTE: 6suomn of n zoMttq pn,md docs mA,dlovc an oppliconfs burden to comply wWi all zonlnp roqu7romopw and oWNn all toqultod pormYd
Irom Iho Boord o!HodUt ConsorvaUon Commission,Dapalmanl of Publb We,ks and odwr applicable pants 9ronWt9 oWhadOes.
/i Yl.