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-� <br /> � <br /> C�C� OFF LIST FOR ISSIIANCE OF PEF2MITS <br /> FaR OFFIC: USE ONLY <br /> ADDRESS OR I�'''G�L: 3�0(�� SHO�Cr1/�C� D� PID: <br /> DESCRIPTI ON OF WORR- 'T Nn P S ((�N <br /> ---------------------------------------------------------- <br /> ZONING R.EVIEW BY: � nn,�,� DATE APPROVED: <br /> BIIILDING REVIEfnI BY: /V I lR DATE APPROVED: 3 `1(�'S3 <br /> ----------------------------------------------- <br /> FEES TO BE CSARGED• Misc. rees Calculated Bv: <br /> TL�N'�/� SIbN FE� <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 SITE INSPECTION <br /> Number of S�C Units OTHER (saecifv) <br /> ------------------------------------------------ - <br /> ZONING CHECX LIST Zoning District: <br /> Fire Depar�;nent: <br /> Post Office: School Dist=ict: <br /> Lot Area: W� dth: De th: <br /> ; <br /> Survey Submitted: Yes N Date of urvev: - � <br /> Pronosed Setbacks : � <br /> � Front (Lakei : Right ide : <br /> P.ear ( Street ) : Leit ;�Side: <br /> Adjacent Struct res : W ��an <br /> .__.__.—.— <br /> Building fieight: D �. Hgt. � Pea Hgt. <br /> Avg. Setback: � Lot Cove age: <br /> Existing j P opos d <br /> r <br /> Hardcover: G-75 ' <br /> i <br /> 75-250 ' <br /> 25a-500 ' <br /> 500-I000 ` <br /> Hardcover Vari nce Require : Yes No Date of Council Approval: <br /> Grading- Staf Approval Da B : Council Approval Date: <br /> Septic: Staf Approval Dat : <br /> Zoning File-� R solutio �- Resolution Date: � <br /> '�,-,,.,___ � <br /> ��tAR7CS (in house) : � <br />