Laserfiche WebLink
� CHECK OFF LIST FOR ISSUANCE OF PERNIITS <br /> _ � ` FOR OFFICE USE ONLY � . <br /> ADDRESS OR LEGAL: �S rV �T v�(� V3(3`t R-0'� <br /> PID: <br /> DESCRIPTION OF WORK: ���� T t � N <br /> • � <br /> ZO�'G REVIE`V BY: DATE APPROVED: 9 -� 5 - � <br /> BUII.DI�tG REVIE�V BY: DATE APPROVED: y -��-vo <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> pERNIIT Yes ✓' No :. <br /> pLAN REVIEW Yes �' No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATER CONNECTION <br /> INVESTIGATION FEE Yes No �/ pA�K�E <br /> SAC Yes No r/ STTEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZOYL�iG CH�CK LIST Zoning District: /22-(�_ - ' <br /> Fire Depaztment: �/�t = Post Office: � c.c,,"— School District: C�C�N� <br /> Lot Area: Sq.ft. 5 2,dSV Acres 1.�°+S � Width 1 Z 3���� Depth �-I b 2 •�9�7 <br /> Survey Submitted: Yes_� No Date of Survey: d� �1� <br /> Proposed Setbacks: . <br /> Front(�ec): y O� '� Right Side: �S� } <br /> . � <br /> Rear(S�eat): 3q5' '-' Left Side: 7. S <br /> Adjacent Strucmres: /�rr-r�c-t+�ro Wetland: n� (/� . <br /> Building Height: Def. Hgt. O. �L Peal:Hgt. c�� l� <br /> Lot Covera�e: p,1� <br /> Grading: Staff Approval Date: — By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # 25°t'7 Resolution: # 1-150 Z Resolution Date: 7-Z`�t 'n� <br /> Shoreland District: y�s <br /> Avg. Setback: � N//� Bluff Setback: N�/� I.ot Covernge: b •1< <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' l�•�C- <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No O� Dace of Cauncil Approval: <br /> REVIARKS (in house): <br /> 7 <br />