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- . � <br /> CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Y Z 2� � � � � PID' <br /> DESCRIPTION OF WORK: ��'- � <br /> -------------------- -- <br /> ------------------------------------ <br /> ZONING REVIEW BY: DATE APPROV�: `�� l L S�I <br /> BIIILDING REVIEW BY: _ DATE APPROVED: � - 12- �� <br /> -------------------- ------ <br /> FEES TO B$ CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes. �No <br /> PLAN REVIEW Yes �No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � PARR FEE <br /> SAC Yes No � SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECR LIST Zoning District /cle.�l/4 <br /> Fire Department: (,c ,.�1 Post Office: �� School District: 6PLo�vc� <br /> Lot Area: �� ��'���id eP <br /> Survey Submitted: YeslX No Date of Survey: <br /> Proposed Setbacks: � � � <br /> Front (Lake) : 3 b� �' Right Side: ��t7 , <br /> Rear (Street) : ZO O� <br /> l Left Side: �Xb� =� <br /> Adjacent Structures: �� �" Wetland: /v�/a <br /> Building Height: Def. Hgt. �•�� Peak Hgt. � •1c <br /> Avg. Setback: Lot Cover ge <br /> Existing Propose <br /> Hardcover: 0-7 ' <br /> 75-25 ' <br /> 250-50 ' <br /> 500-100 ' <br /> Hardcover Vari nce Req ' red: Yes No ate of Coun il Approval: _ <br /> Grading: Staff Approval ate: By: Council pproval. Date: <br /> Septic: Staff pproval Da e: Y= <br /> Zoning File:# es lution # : ResoJ.uti n Date: <br /> REMARKS (in ho se) : <br />