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' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR�OFFICE USE ONLY <br /> ADDRESS OR LEGAL: � <br /> PID: . <br /> DESCRIPTION OF WORK: <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: � - 5 -�,� <br /> BUILDING REVIEW BY: DATE APPROVED: � -s -S� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes t� No <br /> PLAN REVIEW Yes � No SEWER CONNEC'TION <br /> STATE SUR`I-�ARGL Yes � No WATERCONNECTION <br /> INVESTIGA'I'ION FEE Yes No .� PARK FEE <br /> SAC Ycs No �/ SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: (�2-(!3 <br /> Fire Department: (���(q:�c.c� Post Office: �, �- School District: b2o�so <br /> �— <br /> Lot Area: Sq.ft. 3.�7 Acres (b�,�'1�•Z Width /�'�t,�,,�uc.4�/L- Depth <br /> Survey Submitted: Yes�C_ No Date of Survey: f3�L9 '�77 <br /> Proposed Setbacks: <br /> Front (Lake): Sg-I Right Side: I ( S .y �. <br /> Rear (Street): 3 7 c� ' Left Side: /S 3 w <br /> Adjacent Structures: /(J//4- Wetland: 6 7 � <br /> Building Height: Def. Hgt. Z�•5 Peak Hgt. 31•5 <br /> Lot Coverage: ��/}_ <br /> Grading: Staff Approval Date: � - S�5-1 By: �,. Council Approval Date: /1��/� <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: tf Resolution Date: <br /> Shoreland Dist=ict: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> N.� � �s-Zso� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> � 26 <br />