HomeMy WebLinkAbout05070238-ApplicationI or ZnstitutiOnah New Structures~ Additions, Remodels,
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BEST HETHOD OF CONTACT:
LOCAT/ON
Address of Shell Building (If different than Address of Const~u~on)
~, SUYrE # (Jif Applicable)
SCOPE(S)OF~O FDN o STR (
RELEASE: %~' ELEC C3 SPKLR
SEWER U'i'[L1TY
PROVIDER;
SQUARE
FOOTAGE:
ESTIMATED COST OF CONSTRUCTION:
(EXCLUDING LAND VALUE)
[] Hezzanlne or Oec~
Lot Split: Sump Pump: Y i~
any part of.the property lip wrdlln a special Rood
ignation area: Y~N_N
[] DETACHED
[] A'~FACHED GARAGE
0 CELL TOWER (New)
SLAB 0 CELL TOWER CO-LOCATE
DEMOLITION
Signature of Owrier'~~__~ Print
OFF~CE USE ONLY:
INSPECTIONS REQUZRED:
Meter Base
# C~arged Re-
Base Inspections: .. Reviews
Cert. of Occu/p~: ~