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, CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Zl:�L' >�Ly�.►�v� � t.w f�;� <br /> PID: <br /> DESCRIPTION OF WORK: Lr�Z�. i�G <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> ZONING REVIEW BY: <.— ' �..�w. DATE APPROVED: �; �� -�7� <br /> BUII.DING RE'VIEW BY: - � DATE APPROVED: L; `r-� y� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes c/ No , <br /> PLAN REVIEW Yes �/No SEWER CONNECITON <br /> STATE SUR`HARGE Yes �/ No WATERCONNECITON <br /> INVESTIGAZ'ION-FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST zoning District: K�-� ��� <br /> Fire Department: �� - Post O�ce: (.�_�C-�-r�-� School District: �(�1:,�'v� <br /> Lot Area: Sq.ft. N :: c�� Acres � Width -- Depth —" <br /> � <br /> Survey Submitted: Yes_� No Date of Survey: �v ,�,� <br /> Proposed Setbacks: , <br /> Front (Lake): . Z i��� �`= Right Side: 1 [> � � <br /> Rear(Street): �{U� '— Left Side: i �' � <br /> Adjacent Structures: ic� �-c d���: ` Wetland: N i f� <br /> Building Height: Def. Hgt. �, ,�L Peak Hgt. — <br /> �Lot Coverage: <br /> 1 <br /> � Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> f� Shoreland Dist:ict: <br /> ,�} r' Avg. Setback: Bluff Setback: L.ot Coverage: <br /> 1 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 /> REMA]EtKS (in house): <br /> • 26 <br />