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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 4 61-4 0 TO N 1c.4 <br /> PID: <br /> DESCRIPTION OF WORK: QCT (9AAA coer <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATEAPPROVED: Y- �•�� <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 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: I-A- /A <br /> Fire Department: (K43JN1() Post Office: k1AAOQNV) School District: w2-ST6M4 <br /> Lot Area: Sq.ft. Acres 1. 0a Width 10 cl •5`( A&,{ Depth `1 U,•5 <br /> Survey Submitted: Yes bL No Date of Survey: b-30-cf 7 <br /> Proposed Setbacks: <br /> Front(bake): v� Right Side: t S N <br /> Rear (S+Peee): 32,01 + Left Side: <br /> Adjacent Structures: 34 Wetland: /J A <br /> Building Height: Def. Hgt. t3' Peak Hgt. 22--S <br /> Lot Coverage: /y(/- <br /> Grading: Staff Approval Date: V, 3-443 By: Council Approval Date: <br /> Septic: Staff Approval Date: /y(A By: <br /> Zoning File: # Z2-10 Resolution: # _39�Y_ Resolution Date: <br /> Shoreland District: NO <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> 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 />