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. . . <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �0 6 5 �5�4N�0 S 7-�n�`. c.2 <br /> PID: <br /> DESCRIPTION OF WORK: ��� �� '�3 �F 3 P c�� <br /> ZO�tPi TG REV�W BY: DATE APPROVED: / 1 • Z3-o�' <br /> BUII.,DI�'G REVIEW BY: DATE APPROVED: �/• z3 -o S <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 WATER CONNECTION <br /> INVESTIGATION FEE Yes No s� PARK FEE <br /> SAC Yes � No SITEINSPECTION <br /> Number of SAC Units �_ OTHER (specify) <br /> ZONI�TG CH�CK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sc.ft. Acres Width Depth <br /> Survey Submitted: Yes�o _ No Date of Survey: <br /> Proposed Setbacks: <br /> � � <br /> Front(L-�c): `� Right Side: <br /> Rear (St�set): (7 Left Side: O <br /> Adjacent Structures: c� �Vetland: n� !r9 � <br /> Building Heigh[: Def. Hgt. � ,/L Peal:Hgt. <br /> Lot Coverage: �J!IQ <br /> Grading: Staff Approval Date: n/(� By: Council Approval Date: <br /> Septic: Staff Approval Date: N /,a By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: n1� <br /> Av�. Setback: Bluff Setback: L.ot Coverage: <br /> Ezisting Proposed <br /> Hardcover: 0-75' <br /> 7�-250' <br /> 2�0-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RE1�iARKS (in house): <br /> 7 <br />