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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ( Z Z C TONK A W 14 (2-oAO PID: <br /> DESCRIPTION OF WORK: Z 1� (r� lY`' N-r u0 0 A- <br /> ZONING REVIEW BY:---y-/-�-�/�nrN.. -------DATE APPROVED:-- /J �------------------ <br /> BUILDING REVIEW BY: C &VIt, DATE APPROVED: <br /> ----------------------- - <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes No J SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> --------------------------------------------------------- <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Width: Depth: <br /> Survey Submitted: Yes No Da of Su vey: <br /> Proposed Setbacks: <br /> Front (Lake) : fight Si e: <br /> Rear (Street Left S ' e: <br /> Adjacent St uctur s: Wetlan <br /> Building Height. Def. Hgt. Pea Hgt. <br /> Avg. Setback: Lot Cover ge: <br /> Ex' sting Propos d <br /> Hardcover: 0- 5 ' <br /> 75- 50 ' <br /> 250- 00 ' <br /> 500- 000 ' <br /> Hardcover V riance Req it d: Yes No Date of Counc' 1 Approval: <br /> Grading: S aff Approva ate: By. Council pproval Date: <br /> Septic: Staff Approval te: By: <br /> Zoning File: # Resolution # : Resolu ion Date: <br /> REMARKS (in house) : <br />