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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 4(o-L9 Ta N tcAy t E.W t_N ry iL <br /> PID: <br /> DESCRIPTION OF WORK: YJ CT- GyAIZAG ev <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: 5-ZG -90 <br /> BUILDING REVIEW BY: DATE APPROVED: S'- u <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: Ca-1 1 <br /> Fire Department: Mo u"o Post Office: Mov"40 School District: we s-roNl�l <br /> Lot Area: Sq.ft. 32 , 2 3 4 4 Acres .7`( Width Depth 2-x,,0 <br /> Survey Submitted: Yes A No Date of Survey: S' 2l0 ' 9 3 <br /> Proposed Setbacks: , <br /> Front (Lake): Z?� Right Side: f O 6 r <br /> Rear (Street): Left Side: 10 <br /> Adjacent Structures: Zo Wetland: N I A <br /> Building Height: Def. Hgt. 13 . Ic- Peak Hgt. <br /> Lot Coverage: d•(c, <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> ' Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> I Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />