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CHECg OFFLIST FOR ISSUANCE OFPERMITS <br /> - � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL:_ � � �" ����Cr ���� <br /> PID: <br /> DESCRIPTIONOFWORK: ��y�w�p�. <br /> ZONINGREVIEWgy,• �1/ldq DATEAPPROVED: <br /> BUILDINGREi�lEWBY.• DATEAPPROVED: /d •� - o� <br /> � <br /> FEES TO BE CAARGED: Misc. Fees Calculated By: <br /> PERMIT Yes r/' No <br /> P���E� YeS--�;.L N� SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No-�� WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> `�C Yes No SITEINSPECTION <br /> 1Vumber of SAC Units OTHER s eci <br /> -- . (P .f') . <br /> ZONING CHECS LIST Zoning District: �i{�-p ��,�ir�,�► <br /> Fire Department: Post ce: (f� <br /> � School District: - <br /> Lot Area; Sq.ft. • Acres Width <br /> Depth <br /> Survey Submitted.• Yes No Date o Surv <br /> f ey.' <br /> Proposed Setbacks: <br /> Front(Lake): Right ide: _ <br /> Rec�(Street): Left Si : � . . <br /> Adjacent Structures: Wetland.• � - <br /> Building Height: Def.Hgt. - <br /> Hgt. <br /> Lot Coverage.. <br /> Grading.• Staff,4pproval Date: <br /> BY� Council Approval Date: <br /> Septic: Stcr,�"Approval Date: By, �� <br /> Zoning File: # Resolution: # Resolution Date: � <br /> Shoreland District: �Q\ <br /> .4vg. Setback. MCWD Permit. <br /> BIufJ'Setb ck; LotCoverage: <br /> Frxisting Pro osed <br /> Hardcover: 0-75' p <br /> 75-250' <br /> 250-SDO' <br /> 500-1 D00' � <br /> Hardcover Yariance Reguired.• Yes No <br /> Date of Council flpproval.• <br /> REMARKS('cn house): <br /> 33 <br />