Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERivIITS <br /> FOR OFFICE USE ONLY <br /> Ai7DRESS OR LEGAL: ( �l 2 s N-A�y w��„o t�� <br /> PID: <br /> DESCRIPTION OF WORK: 2�c^�w ��- <br /> ZOrZ\i'G REVIEW BY: DATE APPROVED: G- � -�� <br /> BUILDING REVIEW BY: DATE APPROVFD; � -s'-w <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes _,� No <br /> PLAN REVIEW Yes ,/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WATERCONNECTION <br /> IlVVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SI'I'EINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZO�iL�1G CH�CB LiST Zoning District: � c r-�� _ � <br /> Fire Department: Post Office: 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 /> Reaz(Street): Left Side: <br /> Adjacent Structures: Wetl d: . <br /> Building Height: Def. Hgt. Peal: gt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: B : Council Approval Date: <br /> Septic: Staff Approval Date: B : <br /> Zoning File: # Resolution: # Resolutioa Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> '� 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />