Laserfiche WebLink
� CHEC�i OFF LIST FOR ISSUA.��TCE OF PERl�'1zTS <br /> - . FOR OFFICE USE 0�1LY . ' . <br /> ADDRESS ORLEGAL: 2�� � 2A»C� I�� <br /> PID: <br /> DESCRIP'�'Y4N OF�ORb: n1 c.=w (L..-�— c�e s� �vil SR <br /> . <br /> ZOti'Lti'G REVIEti�%BY: D�TE APPROV�D: 5 - t 5-�1 <br /> BUILDING REVIE�$Y: D�T E APPROYF�D: �- r S -d.� <br /> FEES TO BE CFt4RGED: Nlisc. Fees Calculated By: <br /> pEgN1IT Yes � No �� <br /> PLAN REVIEW Yes � No SEWF.�CO�INECTION _ <br /> STATE SURCHARGE Yes � No ��ATERCONNECTION <br /> I�i,'VESTIGATION FEE Yes No PARK FEE <br /> SAC Yes i�10 SITEINSPECITON <br /> Number of SAC�Units OTHER (specify) <br /> ZOti'L',IG C�iECK LIST Zoning District: 2R- I � . <br /> Fire Department: Post Ofnce: School District: � � � <br /> /�,,��o� ,� w ez ca�•�,o ��� <br /> Lot Area: Sq.fc. Actes 5 .ZS ' widch 3'��►� { Depth � 5i°X� <br /> I`�l•o� '�T� <br /> Surve;� Sub.�.itted: Yes�_ No Date of Survey: /Z'�-z-"°o <br /> Proposed Setbacks: � <br /> F.oet (La.ke): �'(�� � RiQht Side: � 100 � <br /> Rear (Screet}: '�0�' + Left Side: (oo� � <br /> Adjacent Structures: /V (� Wetland: Ci`�I i= • <br /> Buildin� Hei�ht: Def. H�t. '3�� Peak H�t. �v� <br /> I.oc Covera�e: /�1 (/� <br /> Grading: Stafi Approval Date: ,5"'• /.S-� � By: �`�• Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoaing File: � 2�5v Resolution: ;�� Resolution Date: Z-��-- D ( � . <br /> Shoreland District: (� O <br /> Av�. Setback: Btufi Secback: LotCo��era�e: <br /> E���? Proposed <br /> Hardcover: 0-7�' <br /> 7�-250' — <br /> ti0-500' <br /> 500-1000' - <br /> Hardcover Variance Required: Yes No Da�e of Council Aoproval: _,__ <br /> gEI�IARb',S (in house): <br /> 7 <br />