Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 22 c�o s NA�c �oo c� <br /> PID: . <br /> DFSCRIPTION OF WORK: (J Eu,� s-rw�25 -+ scr�2v i c.-p p o e� �-v �,�t�c,� <br /> ZO�G REYIEW BY: CQ.{�,.a„ � N DATE APPROVED: �,(- 3 0 •0 3 <br /> BUII..DING REVIEW BY: DATE APPROVID; b-�o -03 _ <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 WATERCONNECITON <br /> INVESTIGATION FEE � Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZONING CH�CK LIST zoning Districc: <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 /> Rear(Street): Left Side: <br /> Adjaceat Structures: Netland: <br /> Building Height: Def. Hgt. Peal:Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Res ution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: L.ot Coverage: <br /> Eusting Proposed <br /> Hazdcover: 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 />