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HomeMy WebLinkAbout058-560-038w ENMONWNTAL HEALTH SHEET ENCLOSED .5 1r� ;� I ❑ APPROVED Iff CONDITIONALLY APPROVED ❑ RESOLVE PROBLEMS PRIOR TO APPROVAL PERMIT CLEARANCE Permit #: Genera/Information Owners Name: (,( C t / �o j? Owners Address: Building Site Address: ark [I(w F / D/414 Date: / 6 a Now AP#:J�OnnO D V0a.9Parcel Acreage: 3 I -? Ac 8weltylnformation Permit Type: ❑ Agriculture Building ❑ Commercial ❑ Industrial ❑ Mobile Home ❑ SFD ❑ Residential Accessory ❑ 2nd Dwelling ❑ Multi -Family >2 units per parcel ❑ Septic Xwell ❑ Other Zone District: -r TZ "2_ Date of Zoning Ordinance: General Plan: --EQ � Development Agreement: Use Permit: Variance: Parcel Is In: Land Conservation Agreement IS No ❑ Yes, check use Minimum Acreage: Nitrate Action Plan No ❑ Yes Violation Area No ❑ Yes Specific Plan ® No ❑ Yes ❑ Chico ❑ D2N ❑ Cohasset Enterprise Zone J§ No ❑ Yes, check use Floodplain p ®No ❑yes Zone: I Panel Number: ❑ Watershed Protection Zone ® No Yes Proposed Use Complies With: General Plan 1W Zoning Pr000sed Use Requires: ❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit ❑ Accessory Building Use Commercial/Ind_ustrial/Multi- Familv Uses: Parking: ❑ Parking Requirements are OK as Shown ❑ Other Landscaping: ❑ Landscaping Requirements are OK as Shown ❑ Other Road and Drainage Improvements Required: ❑ No ❑ Yes Applicable Setbacks: Zoning Code Street & Hi hwa s Fire Prevention 7 Subdivision Ma Front © C/— Side .--S 3 0 Side street Rear 115, O Height Environmental Health Issues: Septic Permit Review: Well Permit Review: Land Development Review: Parcel Created by: ❑ Deeds Agriculture Affidavit Required ❑ No ❑ Yes Designated Well Site ❑ No ❑ Yes Drainage Plan (Com/Ind/Multi) ❑ No ❑ Yes Date of Creation: Legal Access Provided: ❑ No ❑ Yes Deed Reference: Legal Access Required: ❑ No ❑ Yes Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name: Complies with County Standards for Deed Creation: ❑ No ❑ Yes Comments: *Map Date of Recording: Lot: 1 Vim, Block: Book: Page: Conditions That Must be Met Prior to Issuance of Permit: ❑ Verify Legal Parcel ❑ Verify Legal Access ❑ Provide Creation Deed ❑ Comply with condition no. of conditions of approval for the ❑ Obtain a Certificate of Compliance (See Planning Division for application). ❑ Construction across property lines is not permitted (See Land Development for a Merger Application/Lot Line Adjustment). ❑ Comply with Old Subdivision Lot Ordinance (Maps Recorded Prior to Book 17 of Maps Page 23). ❑ Construct road to ❑ Meet parcel size required by zone ❑ Meet current EHD requirements. ❑ Other General Comments: