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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 1050 To4 ww4 mAc-K ng <br /> PID: <br /> DESCRIPTION OF WORK: MAiNT;avAOc.4E Acrd !g 46fL 13u0(0 5 <br /> ZONING REVIEW BY: DATE APPROVED: 1I-Iz-S.7 <br /> BUILDING REVIEW BY: DATE APPROVED: <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes No SEWER CONNECTION <br /> STATE SUR`HARGE Yes lr No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yrs No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: R(L•(43 <br /> Fire Department: W N& uAILZ Post Office: LO w(, L 0rtc.C-- School District: p a-%N o <br /> - Lot Area: Sq.ft.167,. 674 Acres '2i•t Width (67-7t Depth f383 � AvElLsc�P <br /> Survey Submitted: Yes_)c- No Date of Survey: 7 <br /> �j'7� 1�i NtauwNce <br /> Proposed Setbacks: My <br /> Front (Lake): G6-Z-? $.27 Right Side: d`+ so 4- <br /> Rear(Street): 1060' + i age'} Left Side: -49-1d 1 y j.7 f <br /> Adjacent Structures: 3S' 4— Wetland: /y/A <br /> Building Height: Def. Hgt. o.<< Peak Hgt. <br /> Lot Coverage: IJ I A <br /> Grading: Staff Approval Date: AA2&L d 9 c,sgf By: Council Approval Date: <br /> Grxx- cwvo <br /> Septic: Staff Approval Date: 5.W_ By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Hardcover: 0-75' Existing Proposed J <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 26 <br />