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i <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 7.76 /,:u/ <br /> PID: C)5' - // 9 -.2 3 3 w.1 OO o fl <br /> DESCRIPTION OF WORK: -]E /5 <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: 12 a o <br /> BUILDING REVIEW BY: DATE APPROVED: 12-(c) <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes td No SEWER CONNECTION <br /> STATE SURCHARGE Yes �� No WATERCONNECTION <br /> INVESTIGATION-FEE Yes No PARK FEE <br /> SAC Yes No r/ SITEINSPECTION <br /> Number of SAC Units YU-d OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Cymj4 x,i Post Office: >c C4&e School District: of1z/y v <br /> Lot Area: Sq.ft. l3/ �.4 b Acres d 3 Width 5 0 9`t /{x.2 Depth ?%3. <br /> Survey Submitted: Yes C No Date of Survey: 10-Zt, <br /> Proposed Setbacks: <br /> Prunt (Lake): 0�>r Right Side: I Q r <br /> el-ar (Street): 6 Left Side: 1 <br /> Adjacent Structures: Wetland: N I /, <br /> Building Height: Def. Hgt. 2 S Peak Hgt. 3 <br /> Lot Coverage: (3�'I" <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # -- Resolution: # — Resolution Date: <br /> Shoreland District: i e 5 <br /> Avg. Setback: C,->,K Bluff Setback: Lot Coverage: 3N <br /> Existing Proposed <br /> Hardcover: 0-75' V C <br /> 75-250' 2-2-Z c-`jo <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 26 <br />