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. . ti <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z2�p S�o�,d o c� <br /> PID: <br /> DESCRIPTION OF WORK (3 rtsG�.�+i , <br /> ZONING REVIEW BY: ►'�1 I(�1 DATEAPPROVED: <br /> BUILDING REI�IEW BY.• DATEAPPROVED: �-Lz -vg <br /> FEES TO BE CHARGED: Misc. Fees Calculated By.• <br /> PERMIT Yes�r�. 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 /> Number of SAC Units OTHER (spec�) <br /> ZONING CHECK LIST Zoning District: r <br /> Fire Department: Post�ce: School District: <br /> Lot Area: Sq.ft. Acres idth Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetlan : <br /> Building Height: Def. Hgt. Peak H t. <br /> Lot Coverage: <br /> Grading: StaffApproval Date: By: CouncilApproval Date: <br /> Septic: StaffApproval Date: � � � By.� •L Z -dS <br /> Zoning File: t# Resolution: # Resolution Date: <br /> Shoreland District: MCWD Permit: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Ezisting Proposed <br /> Hardcover: 0-7.i' <br /> 75-2.i 0' <br /> 250-.i 00' <br /> .i00-1000' <br /> Hardcover variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 33 <br />