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i'his �,ecti_on as to be fil l( l oi_lt; -Ili lccord�,.11ce of
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P l e e e n t F r o r c c d _ ---1 --_ _ --- -- ----- I-X
;S.lrk the eppropriiite 1,ox to :i_I-ldicc.te tLc u of t.hr p< rcel:
(_A hon-Conf"rrl111 I:ct ': r;d/or `;fracture.
CCif - ----- - -- -- - -= - -- -
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ZoninC Boj.,rd 4ppr0VaI -p C, Perllit 10.0: V �_1in1!ce)
Cour_cil (Special Fxccption S. 10. lO)
ti:3 Yes Protection District Overlly: (Z.O. Sect. .;IV)
cs � ] ro
P_�rkin�; Sl,zce Feduiremento: (Z.O. ect. Pe:Iui1"od—_ __ Pro o_e!?
1,cDdJ Space Re uire;;ler,t,.: Mu.
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Fnviroilm,ental Performanec Yes «l,o
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,lot Plan
Yes �_..,-� j''o ,mite i'lan 1-_A Y! s 7"i:O
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Tlii� se ction for OI F'fCIt , uLe Only:
(�<Apj;roval ns pre ,•entrd:
ifiCZti-�11 1)eCe.'..
Return: iicre i_nfolm� tin ?
[� Dc-nial-: Fe� r,ons:
if A ,.;lic_ Ilt. D,Ite i.no Cfficer
ZONING •
DISTRICT
USE
FRONT .D
SIDE .D SIDE YARD
REAR YARD
NOTES
IX. SITE OR PLOT
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NOTES and Data — (For department use)
IV. IDENTIFICATION — To be completed by all applicants
Name Mailing address — Number, s(rcct, it%, aml ,Cta(c> ZIP code Tel. No.
1. � /l / / r
Owner c r /L iL C- X Q 49c�j j i{. �d(61 Lf C(jd✓ ��G�'1 O
Lessee
Builder's
2.
License No.
Contractor
3.
Architect or
Engineer
I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to
make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction.
Signature of applicant Address Application date
J t
00 NOT WRITE BELOW THIS LINE
V. PLAN REVIEW RECORD — For office use
Plans Review Required Check Plan Review Date Plans By Date Plans By Notes
Fee Started Approved
BUILDING
PLUMBING
MECHANICAL
ELECTRICAL
OTHER
VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS
Date Date
Permit or Approval Check Obtained Number By Permit or Approval Check Obtained Number By
BOILER PLUMBING
CURB OR SIDEWALK CUT ROOFING
ELEVATOR SEWER
ELECTRICAL SIGN OR BILLBOARD
FURNACE STREET GRADES
GRADING USE OF PUBLIC AREAS
OIL BURNER WRECKING
OTHER OTHER
VII. VALIDATION
Building
Permit number /L�
Building , �'
Permit issued C 19 77
Building �
Permit Fee 7`/ C, L�
Certificate of Occupancy S
APPr by: l
Drain Tile �a
G-e Li' Z -
Plan Review Fee S_
TITLE
`�o� roti
(city of Nord auvptou
,LS;dSSFStJ)1TSCtfB
Offire of the '9n9Vtrtvr of Auilbings
APPLICATION FOR
Plot ZONING PERMIT AND
Page BUILDING PERMIT
IMPORTANT — Applicant to complete all items in sections: 1, 11, 111, IV, and IX. Z
O
ZONING
I• AT (LO D I S T R I CYO
LOCATION (NO.) (STREET)
OF BETWEEN � < - AND
BUILDING V (CROSS STREET) (CROSS STREET)
LOT
SUBDIVISION LOT BLOCK SIZE
N
II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D m
A. TYPE OF IMPROVEMENT D. PROPOSED USE — For"Wrecking" most recent use M
1 ❑ New building Residential Nonresidential
2 X Addition(I/ residential, enter number 12 One family 18 ❑ Amusement, recreational
of new housing units added, if any,
in Part D, 13) 13 E] Two or more family — Enter 19 ❑ Church, other religious
number of units— — — — --)� 20❑ Industrial
3 ❑ Alteration (See 2 above)
14 ❑ Transient hotel, motel, 21 ❑ Parking garage
4❑ Repair, replacement or dormitory — Enter number
5 ❑ Wrecking (If multifamily residential, of units ——————— — i 22 Service station, repair garage
enter number of units in building in 15 ❑ Garage 23 ❑ Hospital, institutional
Part D, 13) 16 ❑ Carport 24❑ Office, bank, professional
6 ❑ Moving (relocation) 17 F-1 Other — Specify 25❑ Public utility
7 ❑ Foundation only 26 ❑ School, library, other educational
B. OWNERSHIP _ 27 ❑ Stores, mercantile
8 Private (individual, corporation, 28 ❑ Tanks, towers
nonprofit institution, etc.) 29❑ Other — Specify
9 ❑ Public (Federal, State, or
local government)
C. COST (Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food
1 processing plant, machine shop, laundry building at hospital, elementary
10. Cost of improvement................ Ct'�/�U• school, secondary school, college, parochial school, parking garage for,
department store, rental office building, office building at industrial plant.
To be installed but not included If use of existing building is being changed, enter proposed use.
in the above cost
a. Electrical..................... �j
b. Plumbing ..................... l
c. Heating, air conditioning..........
d. Other(elevator, etc.)............
11. TOTAL COST OF IMPROVEMENT 1$
III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L;
for wrecking, complete only Part J, for all others skip to IV. y
O
E. PRINCIPAL TYPE OF FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS M
48. Number of stories...............
30 Fl Masonry (wall bearing) 40 ❑ Public or private company
31 � 41 Private (sept ic Wood frame p • 49. Total square feet of floor area,
c tank, etc.) all floors, based on exterior f r
32 Structural steel dimensions ..................... 1 (�
33❑ Reinforced concrete H. TYPE OF WATER SUPPLY
t �50. Total land area, sq. ft. ...........
42
34 Other — Specify �Public or private company
p y
43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET
PARKING SPACES
51. Enclosed ....................... r
F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL O
35 Gas Will there be central air 52. Outdoors........................
36 ❑ Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY
37 ❑ Electricity 44 ❑ Yes 45 No 53. Number of bedrooms..............
38 ❑ Coal
39 ❑ Other — Specify Will there be an elevator? 54. Number of Full..........
46 ❑ Yes 47 ❑No bathrooms
Partial.......
I hereby certify that the proposed work is authorized by the owner of record
and I have been authorized by the owner to make this application as his
authorized agent.
SIGNATURE OF 'AGENT
ADDRESS
(NUMBER) (STREET) (CITY)
APPROVED BY TITLE
DATE 19 .
_ DEPT. FILE COPY
ZO
b BUILDING 20-
PERMIT VALIDATION
DATE April 29, 19-22 PERMIT NO.
APPLICANT Paul J. Harlow _ ADDRESS LM An--a}1rA+vIL IRr g}gg
(N0.) (STREET) � (CONTR'S LICENSE)
�tii+ ne �all .l -- NUMBER OF
PERMIT TO A inn ) STORY RPCidanna DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
ZONING 1TRb
AT (LOCATION) 46 Acrebroak Drive F10rp-mce DISTRICT
(NO.) (STREET)
a BETWEEN Off Ran Road AND
a (CROSS STREET) . (CROSS STREET)
LOT
IL SUBDIVISION LOT BLOCK SIZE
m
a
U
O BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
m
Z TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
LL REMARKS: Addition One family_ rpgidenne
AREA VOLUME ESTIMATED COST $ 64O0-W) FEEMIT r$ 21. O
(CUBIC/SQUARE FEET)
OWNER Paul & Sheila Harlow VIA
BUI PT
ADDRESS 46 A _r _brook 'n-r- Piorenna M& BY �Q-effk:t�
(Affidavit on reverse side of application to be completed by authorized agent of owner)
} N0.
a >
`4
19
RECEIVED RECEIVED FROM
DOLLARS
Account Total$
Amount Paid $
Balance Due
"THE EFFIOENCY®UNE"AN AMPAD PRODUCT