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0804-0166 RESIDENTIAL ZONING REVIEW FORM
'ODE COMPLIAIIT`,E DIVISION RESIDENTIAL ZONII�TU REVIEW FORM Job Address r4-1 i CU-Y1 �'© )�n+q- _DR► Le Permit # 0 L)' (L(J C0 Flood Zone Information Alt Development Fees LJ Height Requirements 0 Historical Properties 0 Nonconforming Use or Lot onconforming Structures Iwfveways Setbacks LJ Site Plan Resolutions ❑ Flood Certifications Et Lot Splits ❑ Flood Wav - COBRA ❑ Wetland Identification Shoreline Protection 0' Temporary Uses ❑' Health Department [ IIRD Issues L�_J/ Impact Fees L�,'/Easements E egetation Permit received ` M. ot coverage and square footage 2' Lot and Block LJ Owner'Information SCANNED BY YCODtr actor Informatioat LUCje County General Contractor License Sub Contractors License Q� Signatures Section, Township and Range 1 eMap Number [9 Zoning and Land Use ❑ Lot Coverage C✓YFCC Code L1 egal Description /Plan review for Bed and Bath OC Location — Mainland 12 etc �,"Electric Hook ups (Guest House) E/Road Frontage (County or Private) E Lot & House Dimensions Job Description Jurisdiction ❑ Warranty Deeds Zoning & Land Use LJ Plat Books 1 st Review Date Lj / '1'"7/66 ?nd Review Date/jff /�Z Final Review Zoning Examiner Name Signature REVISED 6.!'_1/06 AY DMG