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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> _- FOR OFFICE .USE ONLY <br /> ADDRESS OR LEGAL. �-�,� PID: <br /> DESCRIPTION OF WORK: ✓YL 0�` t N- G r4-(LA(p(=. N ZLI X�g <br /> --------------= ---------- -- --- ------ - <br /> DATE - -- - ---- - - --- <br /> . _. - `APPROVED: <br /> � " f�, �j - <br /> ZONING REVIEW BY. - ' 1 <br /> BUILDING REVIEW ;. DATE APPROVED: <br /> - '--�-- ------------------ ---- --- - <br /> ---------- --------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes `--N0 <br /> PLAN REVIEW Yes t No SEWER CONNECTION <br /> STATE SURCHARGE y Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes No-U;' PARK FEE <br /> SAC Yes No l/' SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------ <br /> ------------------------------------ <br /> ------------------------ <br /> ZONING CHECK LIST / Zoning District: E-/Z`l (- <br /> Fire Department: Post 6af��ozy lj6e School District: <br /> Lot Area: 7��`t� 5�, f�'- Width: ! OU Depth: 3?Sl•16 <br /> Survey Submitted: Yes NoY, Date of Survey: <br /> Proposed Setbacks: , <br /> Front (Lake) : Right Side: (, b <br /> Rear (Street) : ZLeft Side: to, ± <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peak Hgt. 0.6C'- <br /> Avg. Setback: Al Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance R qui ed: Yes o Da a of Co ncil Approval: <br /> Grading: Staff Appr val Dat By: Counci Approval Date:_ <br /> Septic: Staff Appr al D t By. <br /> Zoning File:# R solution Resolution Date: <br /> REMARKS (in housei: <br />