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, � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: J 7�1Q ,s'iyA/�x w o o/,! D�Z <br /> PID: <br /> DESCRIPTION OF WORK: rt/C w /Z� <br /> ZO�tTIG REVIE`v BY: � DATE APPROYED: �( -�-v`/ <br /> BUII�DI�1G REVIEW BY: DATE APPRO�rED; g- �-o� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes �/ No <br /> PL?.i�i REVIEW Yes �/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATERCONNECITON <br /> INVESTIGATION FEE � Yes No � PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC�Units ���'� r=•c�•r- �o OTHER (specify) <br /> ZONING CH�CK LIST Zoning District: (../Z���- . <br /> Fire Department: Post OfFice: School District: � <br /> Lot Area: Sq.ft. 2o�b Z'1 Acres . Y7 � Width Depth <br /> Survey Submitted: Yes_ c No Date of Survey: �' 2'v`'t <br /> Proposed Setbacks: <br /> ( }: 7 5 Right Side: 1 L� <br /> F�ont Lake � <br /> FEear(Street): �Y� Left Side: � 2� <br /> Adjacent Structures: � �Vetland: ^ <br /> Building Height: Def. Hgt. �e� � Peak Hgt. 3S r <br /> Lot Coveraae: ►y•�4 <br /> Gradin;: Staff Approval Date: 9-�'v`� By: � Council Approval Date: <br /> Septic: Staff Approval Date: n�1� By: <br /> Zoaing File: # 0?-Z4�62 Resolution: # Resolutioa Date: �•Z'Z--o`� <br /> Shoreland District: y�t4 <br /> Avg. Setback ��,k. Bluff Setback: ��/3- I.ot Coverage: f Y• � <br /> Existing Proposed <br /> Hazdcover: 0-75' d <br /> 75-250' 3�•v <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes_� No Date of Council Approval: 3•22-�`I <br /> REMARI�S (in house): <br /> 7 <br />