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- CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z�`'�S WgT 2Tow N PID: <br /> DESCRIPTION OF WORK: 0 EL1C <br /> ------------ --------------------------------��' <br /> ZONING REVIEW BY: DATE APPROVED: <br /> BUILDING REVIEW BY: ,.�..• DATE APPROVED: 7- (0 -cl 5 <br /> ---------------------- ------------------------------------ --- -------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yeses" No SEWER CONNECTION <br /> STATE SURCHARGE Yes? No WATER CONNECTION <br /> INVESTIGATION FEE Yes-wg;�::"No�� PARR FEE <br /> SAC Yes Nom- SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District 2--113 <br /> Fire Department: (,.C.. . Post Office: G •�-• School District: etl <br /> Lot Area: o s z Z. i dth: 416 2` Depth: 7-3( <br /> Survey Submitted: Yes L,�No Date of Survey:—'?- Z- 9.-3 <br /> Proposed Setbacks: <br /> Front (-Lake) : N (14Right Side: 17 2 <br /> t � <br /> Rear (^ ) : 144(. Left Side: Z39'•G <br /> Adjacent Structures: 47- choe Wetland: /V�i4 <br /> Building Height: Def. Hgt. lJ (i4 Peak Hgt. <br /> Avg. Setback L t Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75 <br /> 75- 50 ' <br /> 250- 00 ' <br /> 500-1 00 ' <br /> Hardcover Va iance Re uired: Y s Nc Date f Council A proval: <br /> Grading: Sta f Approva Date: By: Council Appro al Date: <br /> Septic: Staff Approval D te: By: <br /> Zoning File: sol tion : Resolution Dat <br /> REMARKS (inhouse) : <br />