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, . CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> r'�DDRESS OR LEGAL: ZUU�1 SU6A(Zt..uC;;Ut(]S ���Z PID: <br /> DESCRIPTION OF WORR: E� (�`> � — <br /> -------------------------�--�-------------- <br /> --------------- _ , <br /> ZONING REVIEW BY: � DATE APPROVED- I �`i I �-- � <br /> BIIILDING REVIEW BY: DATE APPROVED: � (i - l Z -"`"1� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes � ' No <br /> PLAN REVIEW Yes f No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATER CONNECTION <br /> INVESTIGATION FEE Yes No f' PARK FEE <br /> SAC Yes ✓ No • SITE INSPECTION <br /> Number of SAC Units �_ OTHER (specify) <br /> -------------------------------------------------------------------------------- <br /> ZONING CHECR LIST Zoning District: /�� ��-� <br /> Fire Department: Post Of f ice:��,o,�_!�,r�c;; SchooJ� Di strict:�-��Nv <br /> � , <br /> Lot Area: 3 3 �� v '�' �?U(= Width: !�� �-�C Depth: 2-Zo "�' <br /> Survey Submitted: Yes -'_ No Date of Survey: o�� � y3 <br /> Proposed Setbacks: � � <br /> Front (Lake) : lUO� -� Right Side: �(3 �' (�/ <br /> � � <br /> Rear (Street) : S�r�� � Lef t Side: 30 �=,c� <br /> Adjacent Structures : �/�� wetland: /'1�i`} <br /> Buil.ding Height: Def. Hgt. ��' Peak Hgt. 3� ' <br /> r-. <br /> Avg. Setback: (rtl" l�- Lot Coverage: �i• <br /> Existing Proposed <br /> �-J . <br /> Hardcover: 8�S' � � 4 � <br /> 75-250 ' <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes No� Date of Council Approval: <br /> Grading: Staff Approval Date: ��� By: Council Approva]. Date: <br /> Septic: Staff Approva7. Date: r�1�a gy; <br /> Zoning File: # Resolution #: Resolution Date: <br /> RF�NfARRs (in house) : fGdlNiv�r� c���s��.x; ��'�'�'��v�- or" �i1(UQ�^�'� �``-' <br /> 3� r .���-C��c��- .' c,ti�-<'_. <br />