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�- � �?���°�( 3�z�c� � , <br /> � CHECX OFF LYST FOR ISSIIANCE OF P$R1�iITS � <br /> FOR OFFIC: USE ONLY 9� <br /> ADDRESS OR LEGAL: Z-7��'"� `.'?�t i._� '.✓J, );'7'>E.., �� , PID: zl — /I�� � � 2� " �%�.'�1/ 4 <br /> ----,. /� ,..._- ,. ._... <br /> DESCRIPTION OF WORS: �.- t_ ^ � ' . t'-��r2 • I�':• - <br /> ----------------------- ----------------------- ---_--------�/------------- <br /> ZONING RLVIEW BY: ��A�� - DATE APPROVED .� /y� `d� <br /> BIIII�DING REVIEW BY: d i.�}(�� DATE APPROVED: 3 -�3 -�1 ( <br /> --------------------- ------------------------------------------- <br /> ------- <br /> FEES TO BE CHARG�: Misc. Fees Calculated By: �f � -�� <br /> PERMIT Yes " No <br /> PLAN REVIEW Yes��c No SEWER CONNECTION <br /> STATE SURCHA.RGE Yes ✓ No� WATER CONNECTION <br /> INVESTIGATIaN FEE l; Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECR LIST -----------------Zoning District ,� � � �� ------- <br /> '��.- <br /> f , .� , . , <br /> Fire De�artment: � Y Pos` Office: � �}`� � School District: ��' r- <br /> n / � � <br /> Lot Area: f✓ � (A� -� Width: �2�1 � � Depth: ZQ `� - <br /> Survey Submit�ed: Yes� No Date of Survey: ��- '� `' � � ' � <br /> _, r- �� <br /> Proposed Setbac!cs . � � ' '� � t � <br /> � � ,r � <br /> " (Lake ) : �� ""' r��_ ,,� Rignt Side : � � - s-� <br /> r=v ni <br /> I 1 � �, <br /> �ear (Street) : I� - Lest sice: �� , ` � �'. <br /> Ad jacent St�uctures :�'';/�' '-��" � _ Wet?and: - <br /> 3uilding Heignt: Def. Hgt. � Peak Egt. <br /> ^� ' �' � . a . �, .. <br /> �vg. Setback:' � � ~ Lot Coverage: � � �� '� - <br /> Existing Proposed <br /> r' � � �. . �. r � �.l <br /> Hardcover: 0-7 5 ' � � ?d�� ,; <br /> 3 l � a °./ � �' _. � �f�. <br /> 75-250 ' - `a '�'-�....___.._ <br /> ...____. � <br /> ` , . <br /> M t �� � <br /> '�� � <br /> 250-500 ' <br /> ' .�.,.�n�.t�.�a,c� S a a� �*+ � <br /> 5 0 0-I 0 0 0 � u,���.�.,� � <br /> Hardcover Variance Required: Yes� No Date of Council Approval: 3 - �l`"�� <br /> Grading: Staff Approval Date: �---- By: ' Council ApprovaZ Date: ` � <br /> � <br /> Septic: Staff Approval Date: �-- � BY= ' <br /> Zoning File-� � ��a Resolution �- � 9 3 � Resolution Date: 3 -(l- �Y�l <br /> RgMARKS ( 'n house) : /Y `�' � <br /> � <br /> � <br /> n-�-�,���� �r�- �' �- '�� <br /> ���- <br />