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' v <br /> ` � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z°��o s u ss�x <br /> PID: ' <br /> DESCRIPTION OF WORK: N�w 2E5 • . <br /> ------- <br /> ZONING I�EVIEW BY.• DATE APPROVED: 3- �.o� <br /> BUILDING REVIEW BY.• ,,,� (L,,,,,,,._ DATE APPROVED: 3 6 03 <br /> ----------------------------------����_—_--_----------------------------------------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLANREVIEW Yes ,�' No SEWER CONNECT70N <br /> STATE SURCHARGE Yes ,/ No WATER CONNEC770N <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: <br /> Fire Depamnent: Post O,�ce: School District: <br /> Lot Area: Sq.ft. Acres �dth Depth <br /> Survey Submitted: Yes_� No Date of Survey: Z� �z-03 <br /> Proposed Setbacks: \ <br /> Front (fxrke): J'l v` = Right Side: � 3q' + <br /> Rear (St�eet): ) I�.3 Left Side: 3y•q <br /> Adjacent Structures: N 1 A Wetland: ''1 S' -�' <br /> Building Height: Def. Hgt. 3� Peak Hgt. 3S <br /> Lot Coverage: _ /�r�A <br /> Grading: Sta,f�'Approval Date: 3-6 •0 3 By: �L Council Approval Date: -- <br /> Septic: Sta�`'Approval Date: 3-c•03 By: M �j. <br /> Zoning File: # - Resolution:/� — Resolution Date: <br /> Shore[and District: N d <br /> Avg.Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> Zsasoo� <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 32 <br />