Laserfiche WebLink
�• CHECK OFF LIST FOR ISSUA"NrCE OF PFp,1N1ITS <br /> _ FOR OFFICE USE ONLY . <br /> ADDRESS OR LEGAL: Z`i ci 5 <br /> PID: <br /> DESCRIPTION OF WORK: <br /> , <br /> ZOrEN-G REVIEW BY: DATE APPROVED: S 3u <br /> BUILDrs'G REVIEW BY: DATE APPROVED: 5 3v�t <br /> FEES TO BE CFLARGED: Nlisc. Fees Calculated By: <br /> pERNffT Yes � No -• <br /> PLAN REVIEW Yes c/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATII2CONNECTION <br /> Ii;VESTIGATION FEE Yes No ci PARK FEE <br /> SAC \,o r}f C_ Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONEN G CHECK LIST Zonina District-. (L�2. • (3 <br /> Fire Department: nt Post Office: School District: i0(zzx.J13 <br /> Lot Area: Sq.fc. Acres Z t - Width 7Z2 t Depth `fW ' 2� <br /> survey Submitted: Yes_� No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): 1 V . 5 2 Right Side: 7 3 .6 <br /> Rear (Street): 163. Left Side: 369- 1-2 <br /> Adjacent Structures: N Wetland: <br /> Building Height: Def. Hat. 12 Peak Hat. 3b <br /> Lot Coverage: tJ <br /> Gradi_^a: Staff Approval Date: By: c10- Council Approval Date: <br /> Septic: Staff Approval Date: 5--ref- 0 t By: 6 <br /> Zoning File: n — Resolution: Resolution Date: <br /> Shoreland District: N U <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing <br /> Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RENT LkRKS (in house): <br /> 7 <br />