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. � ,,. <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> - ADDRESS OR LEGAL: I�� S S ttw�yl�,o�� �� <br /> ' PID: <br /> . <br /> DESCRIPTION OF WORK: �.� <br /> ZONING REVIEW BY: DATE APPROVED: 3•27-n a <br /> BUILDING REVIEW BY: DATE APPROVED: 3-Z� - ov <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 WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: !.R•�L <br /> Fire Department: �,o u N✓J Post Office: ���,�t,q School District: t,�e stvn+u�a <br /> Lot Area: Sq.ft. nro c rr,�vs„� Acres — Width Depth <br /> Survey Submitted: Yes � No Date of Survey: e.J �iL� S•Z?�9 i <br /> Proposed Setbacks: <br /> Front(�t): �g � � Right Side: GO� * <br /> Rear(Street): �y� ' Left Side: �3 z� ± <br /> Adjacent Structures: �4�iaG�� Wetland: N �A <br /> Building Height: Def. Hgt. N �✓1 Peak Hgt. <br /> Lot Coverage: No C/�s�✓�,! <br /> Grading: Staff Approval Date: — By: — Council Approval Date: -- <br /> Septic: Staff Approval Date: � By: <br /> Zoning File: # -- Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setbac : /V�/�- Bluff Setback: �J //s LotCoverage: - <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' �`,� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes No OC Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />