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ZONING PERM l APPUCA1ION wwwcoIIT( cfe.LOfIT SV = :0 IeD App Y <br /> PROPERTY OWNER INFORMATION CUSTOMER TO PROVIDE <br /> OWNER NM( <br /> R+ta15_)- £47mY RE4E . Zoning Status;CUP: <br /> aoout:.; 'roma <br /> ab.SISW tip) Deed Restncion:CSM <br /> 6 5E •A-- ir. h. . ./_.► - - n7/ S Variance(i' ) <br /> HOMERI NE Gat Puma ElMA 11GORLS3U STF DIT59@HO TMAIL.0 OR ,_,I <br /> i �• ` VBSLEXY o NE TSCAPE.NE id Site Plan drawn to scale <br /> AGEN- ':NFCRVA-ION ICONTRACOR INFORMATION and includesdimensOns <br /> ACI NI NAVA OnNtt VS:NON NAW <br /> l it=Rsn� _ <br /> lei/ CC�. 4,/its, �Sito Plan includinglocation <br /> N,Pw.rt• ll.‘",' . .r RwuRCSS Of well/septic/2agkjtc jfRzce At- 7b N/NNERt)n Lit. <br /> n [setbacks <br /> ICm'eAFe.t9, y.�N.[V) <br /> 1/ grJe4• L• 4-2593 S✓uPRAcRjeri cth. s3r40 <br /> PHONE ❑Site Plan approval from <br /> 435•/$(o e7 .235' /Ogee' applicabletovmship <br /> Ude!.ADORES EawtAODfl SS URoor plans to stake <br /> i. f.t� -. <br /> ., . 7*.re —.> 6 s. <br /> -=o- P.-v,Io::.`;ov N=o=v..-io . -"p ::accessdane.co-danewl-usi) Elevation of property <br /> ❑ � <br /> PARENT P.NR, LNUMBER CUMHL'I,;X.:r.(: A(,FiE.v. 1- <br /> P"" SFR-08 0.476 frontage drawn to scale. <br /> O v / -' <br /> 1."^.-IIIP:e CION: <br /> ❑Driveway permits <br /> O.,i . _ ' • !•: _. 1k:_. -- (state,county,town) <br /> nnoataS: <br /> 5 é E1/:: 0 b i . ❑Sanitary permits <br /> Cat Or s ioIVBION131.03101.0T131.03101.0T ((public.private) <br /> 3 - iA f 4 ` <br /> PROPOSED PROJECT INFORMATION STAFF REV!LW <br /> PoO.EGTQE 4fIPiKXt /V. 't <br /> /. .Z <br /> X 't CrA Cil 44R 6e W Zoning Dis:rc: <br /> • is project is a new building or structure.MI <br /> Permineau R.A8. <br /> is project's an addition/alteration to an e,dsdrg building or structure. <br /> sVOTARTSFAVICE: Iy� PLRMITMABEn. (Rural Mei-:.. <br /> fwcc K� (new/existing) <br /> EX <br /> NICHT IN FEET I"C mWERa Sron11$ <NMadt4%neauteN) `y <br /> /(v R. 46 am 6. _ VwetialdrF (attplar' NO <br /> AREA TO NEAREST SQUARE FOOShorQand (attachmen,) <br /> T. <br /> (Outside dimensions including unfinished area.attached garages and atdve grade dedR or porches) V <br /> yErosbo D'd Onpermit NO <br /> BAASEMENT. 1ST Ft.00R: <br /> 4 TOTAL SQUARE FOOTAGE: 4 (SEOpoa.disturbance. <br /> aoRooa: dR )Ftaat n filling/access)K 8�3'� SA.!Review tocaion Survey <br /> ESTIMATED CONSTRUCTION COST: YY and available options. 1r _ <br /> (Please mural to nearest dollar) $ 2 0 7 r <br /> 1. The property is within 300 feet of a stream or 1000 feet from a pond or lake? ❑F'es Duo Qcnt know <br /> 2. Is there a wetland or floodplain on or near the property? ❑'(ea Do Dont know <br /> 3. Have you talked with the township about your project and are they agreement! Dos LINO <br /> 4. Has there been a zoning permit issued for this property in the past$years? ❑Yes deo <br /> 5. Is this project associated with a rezone/CUPtvariance(petition/appeal■ _) (leave dank iI none) <br /> 6. Is a location survey required? (see reverse) es alp won't know <br /> 7. Is this to correct a violation? f,��L',`_' <br /> APPLICATION MUST BE SIGNED <br /> (Continue on Back) -. + + <br /> KV Oa <br />