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' ' y CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> � � , <br /> , FOR OFFICE USE ONLY <br /> � ' ADDRESS OR LEGAL: __ �3 3�,p S H o R.� C...�ilr2 1�2 <br /> PID: <br /> DESCRIPTION OF WORK: E�,�Yv�.o��L �^c,,�o JZ �Y9 sr o.v <br /> ZONING REVIEW BY: DATE APPROVED: _--7 � -r�o <br /> BUILDING REVIEW BY: DATE APPROVED: � -� �-+ov <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes _�� No <br /> PLAN REVIEW Yes �i' No SEWER CONNECTION <br /> STATE SURCHARGE Yes �� No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC . Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: �/l.V G��y�,1c� <br /> �/ <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Righ Side: <br /> Rear(Street): Left ide: <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: ff Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Set ack: L.ot Coverage: <br /> Ezisting Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes o Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />