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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 41 0 v t.J.3 tA-tt2Tow N az" <br /> PID: <br /> DESCRIPTION OF WORK: A v01Tt o t..1 <br /> ZONING REVIEW BY: �Q DATE APPROVED: y/,'ri/9 7 <br /> BUILDING REVIEW BY: zg, ( _ DATE APPROVED: ,// /c 7 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes t./ No <br /> PLAN REVIEW Yes No SEWER CONNECTION <br /> STATE SURCHARGE Yes t/ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Y,:s No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: RR-11A <br /> Fire Department: rylAtke flotkoV Post Office: ryip4 P School District: (D2oNb <br /> Lot Area: Sq.ft.1,32.o,532"7 Acres 30.46 Width I,t-1 b Depth <br /> Survey Submitted: Yes k No Date of Survey: ( "18—CS <br /> Proposed Setbacks: <br /> Front (Lake): _ 951 Right Side: (,?6. t"-- <br /> Rear <br /> t=Rear (Street): I So .t. Left Side: 5434 t <br /> Adjacent Structures: 4-(O� -i Wetland: /J(14 <br /> Building Height: Def. Hgt. C9 1= Peak Hgt. 0. v.- <br /> Lot Coverage: /J <br /> Grading: Staff Approval Date: 0, By: "4, Council Approval Date: <br /> Septic: Staff Approval Date: ri(/4- By: <br /> Zoning File: # 2.3 n`{ Resolution: # Resolution Date: <br /> Shoreland District: NO <br /> Avg. Setback: Bluff 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 /> REMARKS (in house): <br /> 26 <br />