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, - - <br /> � ' <br /> � �, CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAI. DESCRIPTION: <br /> PID: <br /> DESCRIPTION OF WORR: <br /> ------------------- ---------------------------------------------------------- <br /> ZONING RBVIEW BY: - DATE APPROVED: �-(z- �� <br /> BDI7�DING REVIEW BY: � � .DATE APPROVED: b - I Z��� <br /> PERMIT ISSIIED BY: DATE: <br /> -------------------------------------------------------------------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No SEWER UNIT $ <br /> PLAN REVIEW Yes No SEWER CONNECTION <br /> STATE SURCHARGE Yes�No WATER CONNECTION <br /> PENALTY Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> OTHER (specify) <br /> -------------------------------------------------------------------------------- <br /> ZONING CHECR LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Width: Depth: <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake) : Right Side: <br /> Rear (Street) : Left Side: <br /> Adjacent Structures: Wetland: <br /> Existing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Dates BY� " <br /> Zoning File: # Resolution #: Resolution Date: <br /> RF.1�lARRS (in house) : <br />