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Trent E 8307 Donrey Outdoor Adv - Billboard " ~ BUILDING PERMIT APPLICATION WORKSHEET r- PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND (Ptease return thte origlnal and your Duiiding plans to the Department of BulidinD and 8etety) I smmm 0 f (Nrol) fml OaportmentlbeOnly "K r qiv) ~16-7T Gbmm 2 P►~ale~t (rot MaIlUp r Rcad ertre 8p~ ~ ZI . p 9 pry ~ 8tate BubalvlalonlPlat Name ~ )m sE:E--- . LM alock O ' / IclOlU w*• DEPARTMENT U8E ONLY rt * w 5 810006 / Zate ProJect No ~ e owa~~ • ` No of 9ulrolnpe r 8q Ft I ' oepth ~n~ 7 8N B■dc-Fiont 0.3g-t ~1)8-2 Re~r ~n Trad Module Pb 1 tlals 19' 2 7?' ~ON ' te cecr ~r stnm ~ . 7 L aIY d Cl , /9 ~ ~ Phone If dilfe►ent tfyn above ( 1 . Firm ~nm~~ Zlp Std0 PMM / ) XR- ■ ■ , uoenae No ' arons It airrenem Man ebow 8 /Ap~nt ptdlffe►~nt M~►I1 1 Buelr~ Addreaa 9 2ip qty Stat ptme ( ) h 12 RwNw Pta~ C7mft (Y/N) Ottrer (Y!N BEPA Exempt (YIN) Q~ 15 Typs VYb~c 17 p (3 MM O New O Repla,oe 0 re ❑ Oemo fJ AddlMter 0 Move 'WO 14 O~eo~f0aNlbrt~ Vz t ' /7 2- GCZ,*r"Z ~ t0 ~"Mw 4! shid Addon Dl~ c,~ ~L~ ' 11 P ~ZY ' Pnone ' Lander $=Addrm • np 7 ary seate ' P,one t 1 Contact Pao=^ Phone It dlHerent than abo+re 1 1 I►ddltbnal Intamstlon ~ . "~'L~ ~~d~i..• i_~ ~ ~ . ri, 1°' . DEPARTMENT APPROVALS • This is iiot a Permit Appllcatlon TYpe (Standard unfess (Indicated approvals requlred In elther "retease' or'release with conditione" otherwiae Indlcate0) apace prior to permillssuartce ) Fast Traak Release Esrly Start Release w lcand 1 Mold 2 ERnlronntintal Hrstlh Q Commerclal, Q Reaidantial W.1101 Collspe O New ConatructioR. 0 81dg elterattonladdlNon Room 200 O Addltional structure. APPLICATION N CondltionslCommente EIT plannlng/Zonlno; p Commerclal. D Cert ot Exemptton, CI Froniage, ~ N 721 Jefferson O Setbaciics; C3 lot wld, 0 tot etze. 0 use/zone, = O CU, veriance, zone chenpe, shorellne, O fence, ❑ Other OonditioneiComments• - + EtgtnMA• p Cammerciel, tJ Residentle{, O Flood Plaln; Q N.811 detenon 0 drafnege O neweccesslapproach, O fence, , Cl rosd improvement~ / f' Qondittons/COrnmente: 0 Ut1qtla: N. @11.lefiemn Omedlttons/Commenta OthK: ~ Pian Exsm Fin Pntr. OortdlUonslComments ~ m 0 - Pro►ect Representetive TetePhone ~ AQendss Pwforminp 8pecle{ Inspeatton ~ '2 ~ ~ C 3 1 Indlaab a0are or attwh conditlons nlillve to iinsl ss bullf spprovaf 2 Inakato aeove or ettseh rsuons for hold . ~ • ' a• ~ o . ~ i • ~ r ,St. No. Ci tiy Date ! ~ ~T Locati,on ~ r;'~ i~ ~ ~ ~ ~l%~.~ ~ • c.~ r ~',...ra _ Leqal ~ O11[1fZI~ ~l 1 r /14 ~ . . A~JdI''S S r Locatia.". Class Traffi c - - ~ _ ~ t N -N r. 1 ~ ~ ~ r i J