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s . . . <br /> CHECK OFF LIST FOR ISS UANCE OF PERMITS <br /> FOR OFFICE US ONLY j���>�— <br /> , <br /> ADDRESS OR LEGAL: �i`�`� ��L�/` ' /X 11 Gv1�` <br /> PID: <br /> DESCRIPTION OF WORK �1(,�U r+ �ltk�t( �l a,r.4 y',�., Z��d S/��L� c`.x.✓ �»-i 4��r,a/ h cus�= rsai*�'� <br /> ----------C�-�-��`"�----��"-��J`�LG.lr�_.���..L'�c.-�c�]------�-�------------------------------------------- �'dc���c� <br /> -------- 1 1 <br /> ZONING REVIEW BY: �/- DATEAPPROVED: Q <br /> BUILDING REVIEW BY: wQ,�.,�r:.,.A..- DATEAPPROVED: (�,•��{ �u-"7 <br /> -------------------------------------�- ��------------------------------------------------------------------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculatecl By.� <br /> PERMIT Yes�_ No <br /> PLAN REVIEW Yes L No SEWER CONNECTION <br /> STATE SURCHARGE Yes �-� No WATER CONNECTION <br /> INVESTIGATION FEE Yes No �--'" PARK FL'E <br /> SAC Yes No �,,.- SITEINSPECTION <br /> Na�mber of SAC Units OTHER (spec�) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST 7oning Drstrict: �� ' �� <br /> Fire Deparh�ze��t: Post Office: Schoo!Dish•ict: <br /> . ,� � <br /> Lot Ar•ea: Sq.ft. .9c��es �i��2- GVidth Depth ��7`�" <br /> Stuvey St�bnlitted: 1'es �� No Date of St�rvey: �P�� V / <br /> Proposed Setbacks: h t�� �+ <br /> Front.�Lcrlce}� ��_ �kt Side: -T <br /> F � <br /> Rear CCt,...N�}: �Z.(�E f be}'E Side: �� <br /> Adjacent Str•arctures: ri f=k Y�'etland: Vl� <br /> Bzrr(cfingHeight: Def. Hgt. ZZ� +' PeakHgt. G.�'}�t GY�d¢.,�-a ��"S��t�`''� '� <br /> ���� – <br /> �'�.b�' ��c=��r <br /> Got Coverage: ���f��-� �. �y, <br /> �: S /0 <br /> Grading: StaJf Approva!Uate: .By; Council Approval Date: <br /> ( � �= �� a �� .. . . _ . <br /> Septic: StnffApprovalDate: }: <br /> 7v�zing File: # Resolittiorr: # Resolutior�Date: <br /> Shorelafid District: / AICIf�D Permit: <br /> Avg. Setback: 13h ff Setbncic: Lot Coverage.• <br /> 6xisting P��oposed <br /> Ha��dcoi�er: 0-7.i' <br /> ?�-2.i 0' <br /> zso-sno� <br /> soo-i000� <br /> Har•dcovei• [�"ariance Required: }as fVo Dare of Coc�ncil�1pp�•oval: <br /> REMARKS(in hocrse): - --�.:—�:-� , _. <br /> / -4,�1/lSA�J <br /> C�w�U L Z J <br /> >; <br />