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DATE K&A! i / ,4:, l
2 i
NA d ? .. A Ar..� // ADDRESS � 3o ' _ 411...__ LOT el
� r
BLOCK / WARD I
SUEDI . p. - ZONE (2_ '
STREET NO. gO. f f K C 66.8 7 r - 1• MENS IONS 3Sd c/ •
SIDEWALK EXISTING YES NO gi
BUILDING GRADE ELEVATIONS STAKES SET AT SITE 8-'r? ,19 84 BY /4
FEE: $2.00 ( 7 4 -A - i
g iti -0 / de-et/
DEPARTMENT OF PUBLIC WORKS
I, the undersigned, owner or agent of the above described pr.,-rty agree to have the
grade established before excavation has commenced.
,/
1 A A....i. --
ZONING/LAND USE COMPLIANCE CHECKLIST
I. GENERAL
• Building Permit # Zoning Re 2 Conforming Non - Conforming
Job Location l' It Dimension I 1 k Ito( 17
Property Owner S-& ' ,U N It Area
II. CCINSIVIXTION DATA
Describe Work: 7)11.17A J - ' / et/l&-ej
NEW CC STRUCrION ADDITION ALTERATIC
Accessory Building Pool Single Family
Fence Deck/Patio Two- Family
Boathouse Sign Multi - Family
Utility Structure Porch Commercial
—
Other (specify) Manufacturing
III. COMPLIANCE CHECKS
Collies Deficient Deficiency /Cents
Use
Lot Width
Lot Area
Floodplain
Front Yard
Rear Yard
Side Yard (R)
Side Yard (L)
Parking
— —
Building Area
Lot Area per Family
Corner Lot
Other (specify)
—
IV. REVIEW AU'IEORITY
The Planning Director, or appropriate designee, mast approve all plans, except
the following: (1) Alterations or interior work when the use is conforming and
when no change of use is proposed. (2) Maintenance items, e.g., siding, windows,
etc., when the use is conforming and when no change of use is proposed.
Instances where work =plies with the above criteria, the permit can be reviewed
by the Building Inspector without referral to the Planning Director.
/ APPROVES Nor APPROVED
Plan Commission Action Required
Variance (s) Required
REVIEWED BY: vetri,e P- DATE: ( 2-C)-(°‘
OWNER . 6' ADDRESS / ;a 0-11 - 40, ./ 4- ' 1
DATE �d O PE - IT # /7�.>/ USE U..
AL ... ..e...,- ,,:__ _ i Wozk consists of
' / DI : CONTRACTOR _
MASON. CONTRACTOR ' ZONE .
Width of lot Z•/..3 DATE9& U-0-19 INSPECTIONS
` / REMARKS
AI L r , ,,,, , �%�! '
v. / 13 11-` �'' -
v
2 ;1 ��
. prii � - 0 MR r
2$ / w o t- A , p- ox 9. -
i ii ......A , ,MAILING ADDRESS
Front of lot
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