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v CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESSOR LEGAL: 44-73 -To r,'1:A A R,o avO <br /> PID: <br /> DESCRIPTION OF WORK: o CL- A3o rt.e,..� + - <br /> ZONING REVIEW BY: DATE APPROVED: 6, -2,z s 5 <br /> BUILDING REVIEW BY- D- DATE APPROVED: <br /> __-------------- ------ ---------- --------------=---------------------------------------------- <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: "- /#4 <br /> Fire Department: (,aN 64:;" Post Office: Zap!t� (i+Pu% School District: O� <br /> Lot Area: Sq.ft. No cN+tr -Acres — Width — Depth <br /> Survey Submitted: Yes�_ No Date of Survey: S-31.11 <br /> Proposed Setbacks: <br /> Front(lee): `t Right Side: T o' <br /> Rear(Street): ZSO f Left Side: ast <br /> Adjacent Structures: 101 } Wetland: #J (A <br /> Building Height: Def. Hgt. r4 /A Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staff A oval Date: By: C uncil Approval Date: <br /> Septic: Staff App v D. <br /> By: <br /> Zoning File: # Re lution: # Reso ution Da e: <br /> Shoreland District: <br /> Avg. Setb k: Bluff S tback: Lot Coverage: <br /> Exist oposed <br /> Hardcover 0-7 ' <br /> 75- 0' <br /> 250- ' <br /> 500-1 ' <br /> Hardcover ariance Requ a Yes No Date of Cour it Approval: <br /> REMARKS(in house): <br /> 7 <br />