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• CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2-4 0 W AKC 1=1(_L6 0-'D AZ PID: <br /> DESCRIPTION OF WORK: ArIZ Q Q4K <br /> ------------------- --------------------------------------------------- <br /> ---------------_--------`-------------- <br /> ZONING REVIEW BY: DATE APPROVED (J- p7r <br /> BUILDING REVIEW BY: OqOS4-U, DATE APPROVED: G - I Z -2 '( <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes Y/No <br /> PLAN REVIEW Yes �io SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes No-7- PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------�nJ------------------------ <br /> ZONING CHECK LIST Zoning District: `f` (. - ( <br /> Fire Department: A116 Post Office: N School District: N �- <br /> Lot Area: z 4*eN/C- Width: Alk- Depth: <br /> Survey Submitted: Yesy No Date of Survey: S 1( ' T-7 <br /> Proposed Setbacks: <br /> Front ( -Z-no' f- Right Side: 1w 22 <br /> Rear (SAPfjeeV) : 1,50 ' -F- Left Side: 250 1 <br /> SO ' + <br /> Adjacent Structures : 4ed Wetland: 1(11/4 <br /> Building Height: Def. Hgt. d1�/a Peak Hgt. A14 <br /> Avg. Setback: Al Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' i <br /> i <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes No OX- Date of Council Approval: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> -7Zoning File:# Resolution #: Resolution Date: <br /> REMARKS (in house) : <br />