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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: PID: <br /> DESCRIPTION OF WORK: <br /> ---------------------- ---------------------------_---- --------------- <br /> ZONING REVIEW BY: VA" DATE APPROVED. 7 /�L <br /> BUILDING REVIEW BY: _ VC DATE APPROVED: ? <br /> - <br /> -------------------------- - ---------- ----------�—------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes JC No <br /> PLAN REVIEW Yes a No SEWER CONNECTION <br /> STATE SURCHARGE Yeses No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARR 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 Date of Survey: <br /> Proposed Setbacks: , , <br /> Front (�.nT: /OU Right Side: LO <br /> Rear (SO, Left Side: S b� <br /> A <br /> Adjacent Structures: 3& Wetland: <br /> Building Height: Def. Hgt. Peak Hgt. /S <br /> Avg. Setback: Lot Coverage: <br /> Existing 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 /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File:# Resolution #: - Resolution Date: <br /> REMARKS (in house) : <br />