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• � CHECR OFF LZST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> 1/ � - <br /> ADDRBSS OR LEGAL: % ..e�7'��.1"�t.�'s.�.=,�., t'' �o�('� PID: � -� =, �i,l _�'�;; <br /> ��� ' -- i. - <br /> DESCRIPTION OF WORR: '�, t 1���� �j l�, ,.,,..? C!CCcC��-�.� ;, <br /> ------------------------ ------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROV$D: /Q - /j- �i`� <br /> BIIILDING REVIEW BY: �YL�``�-�`-..� DATE APPROVED: 1 0• � 3-C! f <br /> FEES TO BE CHARGED: Misc. Fees Ca].culated By: <br /> PERMIT Yes ✓ 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 SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------- <br /> ZONING CHECR LIST Zoning District: G/�"'�� <br /> Fire Department: ��vv��- Post Office: �ac,� Schoo� District: rK�,urrt� <br /> Lot Area : • �6 /1�GG� Width: 1"�D � AY� Depth: ( 9� �t•I S A-� <br /> Survey Submitted: Yes � No Date of Survey: (�- �� <br /> Proposed Setbacks : � / <br /> F�rrnrt (Lake) : /OS� � Right Side:_ <br /> R.a�r (street) : GS ��' Left side: 1 y.i,� <br /> Adjacent Structures : �l`��(f.l� Wetl.and: /V�G'� <br /> Buil.ding Height: Def . Hgt. �•!�- Peak Hgt. �.��. <br /> Avg. Setback: (jf�R-�tM�JGI Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' �( ��D 3Z- Z �� <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes� No Date of Council Approval:�Z�-�j <br /> Grading: Staff Approval Date: !'��1�►' By: Counci� Approval. Date: <br /> Septic: Staff Approval Date: /V`��4' By: <br /> Zoning FiJ�e: # 3- 6� Resolution # : t`� `l b Resol.ution Date: Z-ZSf� `j� <br /> REMARRS (in house) : <br />