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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I U t S To N Icnw r4 20 A✓� <br /> PID: <br /> DESCRIPTION OF WORK: A ato r%,oN t OEGK <br /> ZONING REVIEW BY: DATE APPROVED• 8 o i <br /> BUILDING REVIEW BY: DATE APPROVED; g.Z�• o z <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 /> ZONING CHECK LIST Zoning District: L Q•►Q <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes >'-_ No Date of Survey: 12-6 -583 LoN mac, <br /> Proposed Setbacks: <br /> Front(Lake): 2%5' Right.Side: k-11 t <br /> Rear(Street): 4'rs' -1 Left Side: .Sy t <br /> Adjacent Structures: _Arr c-H%rv> Wetland: jV I A <br /> Building Height: Def. Hgt. o Peak Hgt. 0-1c- <br /> Lot <br /> -hLot Coverage: t41A <br /> Grading: Staff Approval Date: NI/-N By: Council Approval Date: <br /> Septic: Staff Approval Date: NY A By: <br /> Zoning File: # U 2 Z$l t Resolution: # Resolution Date: ' Z Z- 0 2 <br /> Shoreland District: V 2 S <br /> Avg. Setback: _yAa%^r4 ce- Bluff Setback: /V 1A Lot Coverage: Nlyq <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <zo°10 <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No A _ Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />