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• <br /> ZONING PERMIT ISSUANCE CHECKLIST <br /> iNLegal Description r_ j //rs (�1 �Q <br /> Parcel Number: O<f1 l V 2 3`4 - ` .ni 1 _ ►istri tf q -3 legal status? <br /> F .o•plai 47 hore .n.►` nd?(circle/cross oil) <br /> r` <br /> Town: DM-1k Section: Z-3 1/45 ' 1/4 '51)) <br /> Lot 36 Block_ Subdivision/CSM: Co(1 A cc-,.a_ 17)4. k f <br /> Lot Area: I <br /> Address( 4 U (0((`' d 1:74- Number? Iv Post? <br /> KOwner Information <br /> Owner Name,Address: / 4A E'y Pj.4 o� o2g`a ye4's 7 43LOD/nviv . obi4C - — d '/'J <br /> Contractor Name,Address: $L R D l 3 4 tii)/?/ / , ,f a 61,e 4-6- k),ii'L j <br /> U' (Re , Commercial, Ag, Accessory) Typew Add./Alt.) <br /> Census Code: I p1 <br /> I<New Hones/A 4 ditio•• : )• to L --, <br /> Sanita • P• II it req'd: (Y/N),# Square Footage: Z � 0 �S'Z� S�Z.S�/ <br /> #Bedroo •. listed . Basement: ���d �" �� _ -_ <br /> septic re e , req'd(Y/N): First Floor: - X-D 3 S — 90, <br /> (livabl- area/a•• . alt area)<25% Second Floor: -- co ( 3e <br /> Total: Fee: <br /> Culvert Permit Required? <br /> /t54 Alb,Berry,BG,Burke,CG,Deerfield,Dunn.,Mazo,Montr,PIs Sprgs,Rox, Springfield, SP, VT, Westp <br /> Erosion Control Permit Required? Y/N # <br /> Berry,BE,BM,Bristol,Dane,Medina,Perry,Primrose,Rox,York <br /> 0 Special Exception Permit? V�e?Fl.. •_•ne/We d Permit? Rezone Petition#? <br /> (Of)' J (?oa cQ <br /> SITE PLAN(to scale) � <br /> to <br /> Lot Covers e ok? 5 v = � (.Z?, <br /> Lot Widt --O,6 <br /> Setbacks ,--", r <br /> Road yl e(s) T) Width Setback required � Provided Z‘ <br /> e Yards Required(Given): Left (J Right ( 2() ) <br /> Rear Yard Required(Given): ( ) <br /> Field <br /> Floor Plans footprint matches site plan?�/ / ! (9,1 Decks,cantilevered parts of structure: l� <br /> Height: 1 St-or P'1 <br /> Residential Accessory Buildings: <br /> R&A: Floor Area Residence Floor Area Buildings <br /> vs. Required(50%It/100%A) <br /> fj, Cost Estimate: 1 / ? K <br /> Commercial:watch parking,signs,floor plans and disturbed area. <br /> Other Notes: <br /> • <br />