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; , , <br /> ' ! CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I 9 3 0 .s H-o���� �2��e <br /> PID: <br /> DESCRIPTION OF WORK: Q���.� ���,�5�.� <br /> ZONING REVIEW BY: N I DATE APPROVED: <br /> BUII.DING REVIEW BY: DATE APPROVED: /-��t-o Z <br /> FEES TO BE CHARGED: Misc. Fees Calculated 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 ' SITEINSPECTTON <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: ,�t/� C�f-�r�� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres � idth 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: Wetl d: <br /> Building Height: Def. Hgt. Peak gt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: B : Council Approval Date: <br /> Septic: Staff Approval Date: B : <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setbac : Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />