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25A-107 (31) 4SIlM!r, Date Filed r ~°``' File No ZONING PERMIT APPLICATION (§10 . 2 ) I . Name of Applicant : �� t i cam. ���. G,r tic, .-Ft-A, Address : 31>`i T- V Telephone: F `7:L"7 z -- 1 2 . Owner of Property : ► Address : Telephone: 3 . Status of Applicant: Owner Contract Purchaser Lessee Other (explain: ) 4 . Parcel Identification: Zoning Map Sheet# 27T A- Parcel# /D7 , Zoning District (s) (include overlays) Street Address Required 5 . Existing Proposed by Zoning Use of Structure/Property (if project is only interior work, skip to #6) Building height %Bldg. Coverage (Footpz-int)__^_^ Setbacks - front - side --~ - - rear Lot size ---�--�--- r 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 : -, Sketch Plan 1,ZSite Plan 8 . Certification: I hereby certify that the information contained herein is true and accurate to the best of my knowledge. Date: � I����- Applicant ' s Signature: , 1 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ r , - - - - - - - - - THIS SECTI024 FOR OFF US qNL - - - - - - - - - pproved as presented/based on information presented Denied as presented as n for enial : q�- S gna e o Building Inspector Date NOTE: t s suanoe of a zoning permit does not relieve un applicant's burden to comply with all zoning requirement:,and obtain all required permits from the Board of Health, Conservation Commission, Dopartrnent of Public Works and other applicable permit granting authorities. 7/92 TXAS