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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �� /����I�"1 �� 1;�p�1 V�/��V� <br /> PID: <br /> DESCRIPTION OF WORK t r c ro n <br /> ----------------- 1 y c <br /> --------------------------------=---------------------------------------------------------------------- <br /> ZONING REVIEW BY.• � l,G/��� I, ��"'(, DATEAPPROVED: <br /> BUILDINGREVIEWBY.• DATEAPPROiIED: �.3�r d-1 <br /> FEES TO BE CHARGED: Misc. Fees Calcz�lated By: <br /> PERMIT Yes �f No <br /> PLAN REVIEW Yes� No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes No ✓ PARK FEE <br /> SAC Yes No� SITEINSPECTION <br /> Nzrmbe��of SAC Units OTHER (spec�) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> n <br /> ZONING CHECK LIST 7_oning Distr•ict: n L�' ��7 <br /> Fire Depar•bnent: Post Offrce: School Disd�ict: <br /> Lot Area: Sq.ft. .9cr�es Width Depth _ <br /> Survey Stirbmittec�: Yes '1 No Date of Sufvey: � � � 7 �Z ��� � <br /> Propose cks: — � � i „ r�,'l,' <br /> Front Gake): Rrght Side: �r���1.� <br /> , "'� � r �� �U� <br /> Rear t � )`� �� Left Side: `j" ` <br /> Adjacent St��irctures: YVetland: ! U� <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Covei�age: I V� <br /> Gradrng: StaffAppr•oval Date: Bv: Council Approval Date: _ <br /> Septic: Staff�lppr�oval Dale: By: <br /> 7_onirrg Fi(e: #�_ Resola�tia�: � Resolzrtia�Date: <br /> S/�or•elund Distr•ict: NlC6VD Per•mit: <br /> �vg. Setback.• 131erffSetbacic: LotCovei•uge: __ <br /> Existing Pr�oposed <br /> Hnrdcover: 0-75 <br /> 75-Z.i 0' <br /> ?so-sno� <br /> soo-�000� <br /> � <br /> Hardcover l�aj•iance Requii�ed: }es ���o Date of CouNcil Approval: <br /> REMARKS(in hocrse): <br /> 33 <br />