Laserfiche WebLink
�CTiECg Ok'F i�IST FOR ISSUANCE OF �ER�'�'nTS <br /> POR OFFT.CE USE ONLY <br /> �}D�ESS ORLEGAL: 1 <br /> �"� �clC_ � % <br /> PID� � <br /> �7ESCRZP'I'�O�T OF WORK�_��_��%��._����-'���---------------------------------------------------- <br /> ---------- � DATE APPROVED: Z� , <br /> ZOY.�G gE��V BY: <br /> �UIZDIl�IG REVIEtiV BY: . DATE APPROVED; �• 2� - b <br /> � ----------------------,------ <br /> FEES TO BE CHARGEA� Misc. Fees Calculated By: <br /> PER�.�LIT Yes ✓ No _ <br /> PLAN REVIE`V � Yes � No __ SE�VER COiVNECTION <br /> No tiVATER CONNEC'TION <br /> STATE SURCHARGE Z'eS No —� p�,g�{ FEE <br /> IIvVESTIGATION FEE �'es No —� SITELNSPECTION <br /> S AC �Ces <br /> OTHER (specify) <br /> Number of SAC�Units _ ______________________________ <br /> �------------- <br /> -------------------------------------------- � <br /> ZO`�i`I� C�CK LIS'z' Zoaing Distcic�: Z '� . <br /> Post Office: Schaol District: � <br /> Fire Dep3rtment: , <br /> La� Area. Sq.ft. Acres 2 r t�`"�� Widch Depth <br /> 5urvey Submitted: Yes <br /> No Date of Survey: .�� �_ K e�✓w,��- S„"-'.�-'� <br /> Proposed Setbacks`. I I `f� Side: �Vl� � <br /> Fron[�L.alc�-}: �-111V1C�b'1WS� �� <br /> �O, �ves�- �: <br /> Re ar (�e�t): -�e�S ide: <br /> ��.3'acent cr�scnsres; �`V1Gv� ��l�v► tiVet1?�d: ��C� �f- <br /> � c -1�"� �. <br /> �� Pea.E�Hdt. <br /> Euilding Hei�t: DeF, H;t. �(� Z <br /> Lot Covera�e: h 6'k <br /> B CouncL Approral Date: ' <br /> Gradin�: ScaFf Approval Date: y� <br /> �A �y: (�.1G- <br /> Septic: Staff Aporova! Dar=; _ <br /> � Resolut�:oa: R R?solu�ion Da:�: <br /> Zoc�.n� F'a�. _ — — . <br /> Shoreiand Districc: VI G-'�s Fr � L,c:Cove2�e; <br /> p,vg. Setback: Bl��:: �etback: <br /> �t5f�o Pi0�OS2C{. <br /> H�ccever�, G-i�' — <br /> — <br /> 7�-2�0' — <br /> — <br /> 2�'v-��.��' <br /> ��0-''.��': <br /> Za� �1/1 L�:..•� �i �...�..`���. , r . <br /> t—+7'['��.1.'.'`.� '�I Z•.�.�.� .�_ti�.�-. Zl�.... �2� • _ . <br /> r:,11T .����1 (i _ rl'�����1 <br /> i._. <br />