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. , : <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ►315 �s�' �o��v r l,�t�C:, <br /> PID: <br /> DESCRIPTION OF WORK: �4D0�1"ivN <br /> ZONING REVIEW BY: ....... DATE APPROVED: 6 -/�- 0 2 <br /> BUILDING REVIEW BY: DATE APPROVED: b -�7-o z <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes �/' No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Z�,,��.K Acres . 6 ( Width �RR.�;��t.vc Depth <br /> Survey Submitted: Yes�,_ No Date of Survey: 3•5 �O Z. <br /> Praposed S�_tbacks: <br /> Front(beice): y2� Right Side: /Zo' '�' <br /> Rear(9treet�: SZ Left Side: !.$� <br /> Adjacent Structures: �¢r�c�,���j Wetland: /V/A <br /> Building Height: Def. Hgt. (�.k Peak Hgt. <br /> Lot Coverage: �.�( '70 <br /> Grading: Staff Approval Date: -�- By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # "- Reso�ution:# . Resolution Date: <br /> Shoreland District: y�p S <br /> Avg. Setback: � �J�/� Bluff Setback: .- L.otCoverage: — <br /> Existing Proposed <br /> Hazdcover: 0-75' <br /> 75-250' ' <br /> 250-500' 15•�3�o <br /> 500-1000' ' <br /> Hardcover Vaziance Required: Yes No •�- Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />