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. • � <br /> CHECK pT'F i�IST FOR ISSUANCE OF' �'E�'�'nTS <br /> FOR OFFICE USE ONLY� <br /> �,.T}D�ZESS QRLEirAL: ,� � �f C.� ���SP� ��. . <br /> PID: <br /> 77�ESCRIP'TION OF WORK: qr'�c(� (!.� C�Q-C.L -- <br /> ZOY�tG �tEVIEtiV BY: -------e�"--------- DATE APPR.OVED: �/z�a7 <br /> � DAT'E APPROVED: �-�-�-7 � <br /> �U�LDIl�IG REVZE�V $Y: . � � . <br /> FEES TO BE CHA�tGED:^ Misc. Fezs Calculated By: <br /> PERi.'vLIT Yes _�_ No SE�VER CO�TNECTION <br /> PLAN REVIBti�V Yes _�_ No �VA��CONNECTION <br /> STATE SURCHARGE YeS _../� �O p��{ FEE <br /> INVESTIGATION FEE Yes No ✓ <br /> SAC �es No �/ STTEIl�TSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> --------------------------------- <br /> --------------------- <br /> - ------ 'Q <br /> --------------------- - <br /> Zpylt�tG �CH�CK LIST Zoaing Districr. - � , <br /> Fire Deparcmenc: Post Office; School District: � <br /> Lot Area: Sq.ft. No C (�Acres � Width — Depth � <br /> Survey Submitted: Yes 'x Irio Date of 5urvey: on� ��� �2--�-cxo <br /> Proposed Secbacks: • <br /> Froa[(�ktj� _ hA �ioht Side: 'ho clro•+q2 <br /> Rea.r(��'�" 135�� Left Side: 1�v c.�4��-�/!�- <br /> r�l�j3.�`.P�f Srnir��tr�:: hb �t/arl2rld; �.v(Lf/Z1lL� T� �IClI�7" Of'//G(/S� �/7�Jo�L3 <br /> pro�cc�c(aes nof /nclyG+' b�lfi� re��r.�.,�✓�- <br /> auildin' Hei�t: DeF, �-Igt, /l! (�- Peal: Hot. <br /> Lot Covera�e: 110 ��W'�l4' - <br /> B o. Council_Approval Da[e: ' <br /> GradLn�: Scaff App:oval Date: ��n C(��� Y� <br /> Sep[ic: S�aff Aporov� Date: �Y� 5.�.� <br /> Zoan� File: � — Resolutioa: R � R?solution Da[e: �- <br /> Shorzland District: nA <br /> Av;. Setbac�:: B!uf;Setback: L.o!Coverz�?: <br /> ��S��o Proposed <br /> H�ecover: G-7�' <br /> 7�-2�Q� <br /> 2�0-���+.;' <br /> 5C0-1 C�C�' <br /> �-1ar�,`��.;2' "Y Z:�.:.2 `'_:;C:i2J�; `;�� �;� �=-- G: Lv��_� n�_�� — <br /> r.~_.'�L'-'�:-i� �.Ln h0'��): <br />