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CHECR OFF LIST FOR ISSIIANCE OF Pffi2MITS <br /> FOR OFFICE USE ONLY � <br /> ADDRESS OR LEGAI�: 2 ���� �IXTI� � �f-� /�ID: �"'. ► ��� .z. � 3 I DC�l� <br /> . . ! ..� � , ^���. 3�" - vvl�D//Vl0 <br /> � . ,.� <br /> DESCRIPTION OF WORR: � I 4 i �' � �t�' �` '�� � - �� � <br /> -------------------------- -------------- <br /> ------------ � -- - �---- <br /> -- - -------- � <br /> ZONING REVIEW BY: ��Y���1 DATE APPROVED � '" � �� ' <br /> BIIILDING REVIEW BY: DAZ'E APPROVED: ( cU - �-� p <br /> � <br /> �����������_��������� ���������������:�������������������: . ���,� � 0.4`_��_��������' <br /> FEES TO BE CHARGBD: Misc Fees Calculated By• � ;/ '/` �1 <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 SAC Units --- OTHER (specify) -- <br /> ------------------------------------------------------------------------------ <br /> �, ,,.. � � <br /> ZONING CHECR LIST Zoning District: �� �� �... <br /> Fire Department: f- � �-- � Post Office: � , m. � School District: ,�� � _:t�l���(� <br /> , , <br /> L <br /> Lot Area: �� ��� ,� � Width: L� ;7"'� !' � Depth: D�? - <br /> Survey Submitt�d: Yes� No Date of Survey: �' 2 y- �s'';� <br /> Proposed Setbacks : � , _ <br /> J"� .�. <br /> � 1 Front �T� �� � Right Side:�.fa� � <br /> J <br /> • _ <br /> �- � ! <br /> �t� Rear (£�Y_�}) 10 �-{� �33 Left Side: f ?!� ` �.'� <br /> ; <br /> Ad jacent Structures : /` t;���; ��4: Wetland: �d/�� <br /> , ► <br /> Building Height: Def. Hgt. %��'-., � Peak Hgt. t.`y'7 <br /> , �,. . <br /> Avg. Setback: /� %� Lot Coverage: �' -� � <br /> Existing Pr000sed <br /> ��.-� ���`' ; <br /> Hardcover: 0-75 ' '��+�. Q�'J G��_g QO <br /> 6 <br /> 75-250 ' ��' <br /> zsa-Soo � I% � � ,� � <br /> + . <br /> soo—z000 � <br /> Hardcover Variance Required: Yes No �� Da�e 'of Coun(^!i\ l Approval: <br /> ��- T � , ��/��,����.���.,� f � <br /> Grading: Staff Approval Date: =� � By�v�` <�� Council �Approval Date: <br /> ; � <br /> J <br /> Septic: Staff Approval Date:��� � � `T �.� By:l�'v�__ � <br /> i <br /> Zoning File:# -----�' Resolution #: '-- "� Resolution Date: � <br /> , <br /> i <br /> . . i <br /> P;��S (in house) I , + <br /> � '" ' � .r-� • '% � "_ • , r ) ,`' _.t)f'L.._ t ' � �-,' <br /> r�> �- C- - <br /> . � ,� � , • • ` , . � - . <br /> > <br /> ( ��. • � - � . , , ; <br />