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05110039-Application
STATE ZONING: SCOPE(S) OF C] FDN C] STR ~ MECH '~ PLUM SQUARE RELEASE: C~ ELEC C3 SPKLR OTHER(S): ' ' _ FOOTAGE: PROVZDER: (EXCLUDING LAND VALUE) 'S (If UR: [~ YeS [] NEW STRUCTURE Manufactured Does any part of the property lie within a special Flood ~, SLAB C] CRAWL SPACE [] C~) POST&BEAM C~ BASEMENT C~ DEMOIJT~ON (or POST & PIER) WALKOUT: Y_~N lAC 12) regarding ¢ Signature c Under Slab Filing Fees: # Charged Re- Base Inspections: R~ Add~onal Fe~s