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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: S-OCD J-ONKPID: <br /> DESCRIPTION OF WORK: A00(1l00 <br /> -------------------- ------- <br /> ZONING REVIEW BY: DATE APPROVED: b •2A- <br /> BUILDING REVIEW BY: DATE APPROVED: 10 -?ib-% <br /> ---------------------- -------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes t.� No <br /> PLAN REVIEW Yes ,i No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes Noc/' PARK FEE <br /> SAC Yes No-� SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ---------------------- --- <br /> ZONING CHECK LIST ZoningDistrict (-A-/ <br /> Fire Department: Pos ' 6rhool District: <br /> Lot Area: 11V �//Widthr_- ; D h: <br /> Survey Submitted: Yes�� No Date of Survey: 0f%( F(L <br /> Proposed Setbacks: <br /> Prorit (Lake) : <br /> Right Side: N�A <br /> Rear' (Street) : � (p�'t Left Side: <br /> Adjacent Structures: /¢T1MC4fP`V Wetland: /VIA <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Avg. Setback: C • (G Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' <br /> 250-500 ' Z"JJOs Z.S OS-Oro <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes NoX Date of Council Approval: <br /> Grading: Staff Approval Date: A /13y: il Approval Date: <br /> Septic: Staff Approval Date: y: <br /> Zoning File:# R olu io #: esolution Date: <br /> REMARKS (in house) : <br />