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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2-iO"7 W ALT emS Po RT L-*, t e. <br /> PID: <br /> DESCRIPTION OF WORK: G Srt- — o�r,o," <br /> ZONING REVIEW BY: – DATE APPROVED: 0-Zg_oz <br /> BUILDING REVIEW BY: DATE APPROVED: % -va -oz <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT No <br /> PLAN REVIEW Yes ✓ No SEWER CONNECTION <br /> STATE SURCHARGE Yes _,Z No WATERCONNECITON <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: LrZ-I i3 <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Z4953 Acres . 5?3 Width Depth <br /> Survey Submitted: Yes_ cL No Date of Survey: 10-6-9-7 <br /> Proposed Setbacks: <br /> Front(Lake): 106' Right Side: J�4'-k <br /> Rear(Street): 101 At Left Side: 10 ST RAMT a 1 06 <br /> Adjacent Structures: ArTAc K ro Wetland: VIA <br /> Building Height: Def. Hgt. 04- Peak Hgt. 0.k <br /> Lot Coverage: <br /> Grading: Staff Approval Date: -- By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # of-a914 Resolution: # Resolution Date: 8-26- o r- <br /> Shoreland District: yes <br /> Avg. Setback: p•IL Bluff Setback: til el Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' 2s8.a ?1H.01L <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No ?C Date of Council Approval: <br /> REMARKS(in house): <br /> - 15,–eA A-TrA-r-444 6 60-f �c�t w�+ — !k:-),rPw.ac Af:l -u T - P(Ary /u V1 <br /> r� <br /> 7 <br />