HomeMy WebLinkAboutBLD2001-00757.TIF��L 00001
aTYa xLNTpx RAXwxa osFMTMExi
p.o. eo5ewwl xpttx mawAVyaaw
sae.esµwaalaassrH¢Z
ZONING CLEARANCE PERMIT
1, Peril # 06'w 2�
Co
Owner: K- . H • Co I Phone #: : 294' 4681
E -911 Address: 14, 50 ' (;bAAON3 D )A t e OI `� (plIr.o(v ( ) Existing
PIN: 363'q �'Y`t ( Zoning District 1�- • Z�
Flood Plain ( ) Yes ( —1 no Census Tract #: �)
(11 Yea, Requires As Built Survey Upon Completion)
( /A Amours of Area Disturbed Permit Required: Gradi Erosion Control
TY FP RMT NEEDED:
( New construction ( )Sign ( )Mobile home ( )Remodel ( )Accessory
( ) Addition/akeretion ( ) Service Change ( ) Structure Moving ( ) Demolition
Description of work: - TO CO MS-nw C."( A ISM 2 Pfn rJt� I -' M )" J' EF�4 G
C ESTIMATED COST:
( Single - Family Residential
( ) Commercial
( ) Multi - Family Residential
( ) Industrial
UTILITY SERVICE: ( ) N/A
Electricity: ( ) City of Newton
( Duke Power
Water: (. dY of Newton
( ) Well
Sewer: ('j city of Newton
( ) Septic Tank
( ) Assembly (Must be approved by Fire Dept)
( )Non- ProfdGovemmental
Driveway Permit Required ( ) Yes ( ) No
Driveway Permit Approved: Date:
RE UI ED BA K ( ) WA Setback Inspection DatelBy
Front _/ / I
Side:
Side street: -
Rear:
1 do M1arohy ceNry Mat Me mrNalrle embmanb m accurem and cortact m Me hest of mY unMretestlhm and knowNEpa an0 mat I apm m conmlm mail City
Ordinances and Lawe a the slab of Nord Wro11m regulathp such work and am pans or specifications; submllmd. who my signature below I assume
respomlNllty for all anon and ammsloM o/ the trmrmed. provided on this eppli atlm together arm any Nana amMe other documents nasocmmd with Me
Signature of Applicant �/f^� ��l Date Pt•1. IS za*
Authority of Applicant: ( ) Owner Contractor ( ) Agent ( ) Other:
j AN iz zo�%.c.
Data of Approval Ignaturs of Approving Authority
emit fee: ( )$10.00 ( 1 ) $15.00 ( ) $2G00 ( ) $25.00 (' $30.00 ( ) $35.00 (/) $40.00 (/) $45.00 ( ) $60.00
/
Receipt # l0' 3 L.7 `? Date Fee Paid )/ ( 2 /O tp
( 1 I hereby request that a vested right be granted upon approval of this Zoning Clearance Permit in accordance with NCGS 160A. 385.1.
THIS PERMIT EXPIRES IN SIX MONTHS OR AFTER A ONE YEAR LAPSE IN WORK