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, � <br /> � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: )� ti�� f ;; �� i c-_:�'_,�����`_. '����_�.'v c. <br /> PID: <br /> DESCRIPTION OF WORK: i����! r.�': t;,.�` ��v`_� ',�'ti:+ ;�,� �'���� <br /> -------------------------------------------------------------------------------------------------------------------- <br /> ZONING REV�W BY: ,�-�'.-� (�{,��,c,.,_ DATE APPROVED: !! -:.�r- �;7 <br /> , ��_ <br /> BUII�DING REVIEW BY: �� c. ;. - �,�,..—.- DATE APPROVED: : 1 � i � ; -`; ,` <br /> -------------------------------------------------------------------------------------------------------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes • No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SUR�I�ARGL Yes �- No WATERCONNECTION <br /> INVESTIGA'ITON FEE Yes No . PARK FEE <br /> SAC Y;:s No � SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONIrTG CHECK LIST Zoning District: �__[���i H <br /> Fire Department: �.<=�r�v �-w�1�-�- Post Office: `ti'.;�y`.�4�T�-) School District: ��i Z e N�- <br /> Lot Area: Sq.ft. `�lr�Z C� � Acres . '�:�, Width ; `;-' � � Depth _:. 4�.�:_ <br /> Survey Submitted: Yes X No Date of Survey: I t - �"t-`'i"7 <br /> Proposed Setbacks: , .t <br /> Front (Lake): _ 3� �' Right Side: �4 � <br /> Rear (Street): k "L� �= Left Side: !��� � <br /> Adjacent Structures: �i �ua Wetland: i�. �r� <br /> Building Height: Def. Hgt. , � Peak Hgt. - <br /> Lot Coverage: �;.�� <br /> Grading: Staff Approval Date: ; ; - ;; � `': � By: ::��.r�ti�r'�Council Approval Date: ' <br /> Septic: Staff Approval Date: /; ;Y', By: - <br /> Zoning File; #� Resolution: # `' Resolution Date: F$�`�z�� u� -L`''�� % <br /> Shoreland DisLict: �y�5 <br /> Avg. Setback:' ��r�,'--�,�,��k- Bluff Setback: �� ! �' L.otCoverage: �__;,: � _ <br /> � Existing Proposed <br /> Hardcover: 0-75' �`''�� �s� � <br /> 75-250' '� � - ,,�"�� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes No Date of Council Approval: `�� � �'��' <br /> REMARI�S(in house): <br /> � 26 <br />