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. r �,,�,c t��' _ 8�3��0 . <br /> r. �j�c-f��i2l1�L/f L� <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS ,_..�e��c� <br /> - FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: (o Z S �P 2 t N(0 1-� 1 l�L R—o d�� <br /> PID: <br /> DESCRIPTIONOFWORK: [3�SL:MI��- �r�tSN <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: N I f� DATE APPROVED: <br /> BUILDING REVIEW BY: �,Qo ,,,.,� DATE APPROVED: $ - Z3-C�� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> PLAN REVIEW Yes ,/' No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: �0 G1�/�N�G�; <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right S' e: <br /> Rear (Street): Left Si : <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peal:Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Set ack: I.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />