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� � TEMPORARY CERTIFICATE OF ZOI�'v� �OMPLIANCE
� i � AND UTILITY CONNECTION PERNIIT � Z ����
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ADDRESS ZONING (o�ce use)
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LEGAL DE.SCRTPTION (o�ae use oniy)
LOT BLOCK ADDTTION PID
OWNER / '
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TYPE OF WORB. p New C.a�uar� pDeck pPaad► xo�n� pR�s�ug D� �� ❑ g��
�Aaamon p� Chr�r �
CODE: DI.R.C. �LB.C. ❑ � � " � `
'l�pe of Co�tcuction: I II III IV V A B Q�
Occupancy Gm�: A B E F H I M B S II PgOJECt COSTlVAI.UE S
Diyision; 1 2 3 4 S (ettdeiieg laed)
i nere�r o�y a� i�re r�ea inio�ation an tlris applira�on wl� is tiu ffie 6� af my lmaiwle38e tme and oonect I abu dco[y ffi� I aou ffie owna or �umo.�oa �rnc t� r�e
above- aod thai aae6otm tD att e�oog s� aiod local Iavvs aod wB pweeed m somndaaoe with mbmit�ed Pleas. �. 'C./
official can tha pamit gor' I haebY ag�ee tl� t� cFty afficiat ar a de�ore may �er epm tlrc pmpectY m P�
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Permit Vatuation Pazk Support Fee # E
Permit Fee S SAC # ;
Plan Chedc Fee S War,e�r Meter Siae S/8"; i"; S
State Surchar�e 8 Pressnre Rednoer $
Penalty S Seaer/Water C.a�oa Fee # S
Plumbing Peimit Fee S Waber Tower Fee # S
Mechanicai Permit Fee S Bu�der's Deposit S
Sewer & Water Permit Fee S � s y
Gas Fireplace Permit Fee S T(?TAL DUE S
'Tlus A�n sa�o�es Ywr � Peo� w� AnroTd peid � NO.
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This g ro outity tLat the roqoe� m the aLowe a�i�ion and � dawme� is in a000naanoe with me eYtg zaoi� ori3maooe and may praoeed ai necp�ea. This aocomenc
when signed by the Citq Plamer m�s a o�pocazy Cen�e �Tmiog m�oe aad atfoors ao�ction �o o�o�e_ Bek�e ood�oey. a CauSc�e �Oa�opaney mnst be
i�sst�ed.
plffini� Director D�a6e Specaat Cbaditioo�. if ay
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