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PLOT PLAN FOR DEPARTMENTAL USE
FOR DEPARTMENTAL USE Application for Certificate of Z ❑
Draw below,to scale, a plot plan showing: pP� Zoning Compliance g C liance p
Checked Initials
1. Dimension and shape of.the lot. 1.
2. Front street name. 2. Building Permit/M, Certificate of Occupancy ❑ checked and approved.
3. Side street name if corner lot. 3,
4. Sizes and location on the lot of buildings already existing. 4.
5. Location and dimensions of proposed building or alterations. 5. Building Inspector ✓ Date �3
6. Front yard,side yard,rear yard setbacks. 6.
7. Locate and describe any fences,walls,hedges,signs, 7. Issued Building Permit No. 7s Date
front yard trees and shrubs,green belt.
Location and size of required off-street parking and loading. 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
Concrete
Reinforced Steel
Grout Blocks
Bond Beam
Frame
Roofing
Room Ventilation
Kitchen Vent
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
i Stop Work Order Released
Give brief report of spe isNAnu ual con ' 'o
�=4
Job completed Date
— •p+�"� Building Inspector
YG N 3 Certificate of Zoning Compliance No.— Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC.LA