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. CHECK OF'F LIST FOR ISSUANCE OF PERi1�iITS <br /> � � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: _ I 2Z S si-���zCL�N� t0 � . <br /> PID: <br /> DFS CRIPTION OF WORK: I Z x� 1�( s�-��—t0 � - <br /> ZO�t7�ti G REYIEti�BY: N � ~ DATE APPROVED: /� -27- �`d <br /> BUII..D .J�i IG REVLEti�BY:. DATE A.PPRO'YED: !@• ZZ-�S�0 <br /> �'EES TO BE CHARGED: � - Misc. Fees Calculated By: M <br /> PERMIT Yes r/" No ' <br /> PLAN REV�W Yes v' No SEWER CO�TNECTION <br /> STATE SUR�HF�RCr� Yes c/ No '�ATER CO�TNECTTON <br /> INVESTIGATION-FEE Yes No P?,RK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units `OTHER (specify) <br /> ---------------- ----- --- <br /> ZONING CHECK 1,IST zoni.ng Districc: L2-1 f} � <br /> Fire Depar�enr. ��N�, `��� post O�ce: �,�� 4-y}�. School District: d(tt�r� � <br /> Lot Area: Sq.fr. 1.14� Acres_ 5 1,�.3`1 tiVidth ( � Depch _ �f Z6.�t�7 i4t.Q <br /> Survey Submitted: Yes_!C No Date of Survey: _pN �-((.,� <br /> Proposed Setbacks: <br /> Front (Lake): . ��S�� -�- Right Side• (g` + . <br /> Rea�(Street): 23 3�'� Leh Side: �3� �= <br /> Adjacent Structures: lo' tiVetland: 2� � -1- <br /> Building Height: Def. Hgt. 0 .�c Peak Hgt. — J <br /> Lo[Coverage• (�. lC <br /> Gradin�: Staff Approval Date: --- By: — Council Approval Date: — <br /> Septic: Staff Approval Date: -- gy• �-• � . <br /> Zonino File: # 2y Oq Resolution: # y I y Resolution Date:� y (`{�7 • <br /> Shoreland D'uc.-ict: y��5 � <br /> Avg. Setback: _ ,��,2 Bluff Setback: /�� Lot Coverage: — � <br /> � ' E���� Proposed � <br /> Hardcover: 0-75' <br /> 75-250' . . y� , � • <br /> 250-500' . • <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes� No Date of Councii Approval: d ' Z�l-�l$ <br /> . � <br /> RE11�7ARKS ('in house): � <br /> z - � . • . <br /> : ��� � 26 <br /> . �t-... . . <br />