Laserfiche WebLink
t CHECR OFF LIST FOR ISSDANCE OF PERMITS <br /> • FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 53� R u SS�--�- �v e PID: <br /> � <br /> DSSCRIPTION OF WORR: � ����' <br /> ------------- <br /> ----------------- <br /> ------------------- . <br /> ZONING REVIEW BY� DATE APPROVED' (j- ��--I"�1 . <br /> - <br /> DATE APPROVED: 6 - Z 1-cJ S <br /> BIIILDING REVIEW BY:_ _ ----------- <br /> -------- <br /> ------------- <br /> FEES TO BE CHARGED• Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> �/ I,Ja WATER CONNECTION <br /> STATE SURCHARGE `�eS No p�tK FEE <br /> INVESTIGATION FEE Yes SITE INSPECTION <br /> SAC Yes No <br /> OTHER ( specify) <br /> Number of SAC Units -------------------------- <br /> -------- <br /> --------------------- 2�1,� <br /> ZONING CHECR LIST Zoning District: <br /> r Po Of ' c . `'SchooJ. Di stri ct: <br /> Fire Department: � <br /> Lot Area: <br /> Wi th: <br /> Survey Submitted: Yes/� N° <br /> Date of Survey: 6 - J "� 3 <br /> Proposed Setbacks : S o ` Right Side• /V�� <br /> F r o n t (L-zr�c�e) : <br /> Rear (Street) : ZS � Left Side: !C? ` <br /> Adjacent Structures : Z1 � <br /> Wetland: N�� <br /> Building Height: Def . Hgt. C�, K- _ Peak Hgt• C� •<< <br /> Avg. Setback: Lot Cove ge: <br /> Existing Propos d <br /> Hardcover: 0-75 ' <br /> 75-250 <br /> 250-500 <br /> 500-1000 <br /> Hardcover Varia ce Requ red: Yes No <br /> Date of ouncil Approva�:__ <br /> Grading: Staff pproval te: Y� <br /> Coun il Approval Date: <br /> Septic: Staff prova� Dat : By� <br /> Zoning File: # Re o u ' on # • Resol tion Date: <br /> REMARRS (in ho se) : <br /> � � � �-- � l �- � �, ( i���'� �-z� `� <br /> ;y-� <br /> --w10 �ec� � � � 1����. - <br />