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� ! 1'EMP4RARY CERTIFICATE OF ZONIl�TG COMPLIANCE
U I � AND i;f7�'II,I'i'Y CONNECTION PERINIIT
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ADDRESS
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LEGAL DBSCR�TIUN (o�ae use onty} '
LOT BLOCK
ADDTTION PID
OWNER '� (ghon�e)
(Name}
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(Cantact Name) � � �� - _
(l�ddxess) � �' t�c' �
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TYPE OF WOB,S C1� � DU �
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CODE: C�$ CI�-B•C. �
Type of Co� i II IIi IV V A B ��� Ct�rTIVALIIE � ��� �
�� �: A B E F H I M B. S II ����
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� is � mehest of m9 tmowk� �� aoaect. I�so a�af'9 t�I am u�e a�er ac�u�ad a� f� ene
I hereby catiCY 1h�t I h�re fla�sLod i�ocm�°° oa this� afl �� aad lotal ls� and w� pmoeed � a000�u►oe ��� I am awaie that tffi bu�din8
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X �s r.�a�e xo.
� # $
Park Suppatt Fee
Permit Valuatian SAC # S
pernnit Fee � S
3 Wa�er Met�t Srae 5!8' ;1
Plan Check Fee � � _
State S� ; �ewerlWa�er �n F� # �
Penalty ; # S
$ Wa�erTav�ecF�
Plumbing p� Fee Btn7d�s D� �
Mechanicai Permit Fee z S
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Sewer 8t Water Permit Fee S TOTAt. DUE $
Gas FirePla� Permit Fee �
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B � �s in ai000cd�oe �die C�YT� � and may P�� of Oocu�l' must be
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