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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z(( O W y z l (I y3 <br /> PID: <br /> DESCRIPTION OF WORK: (1.0 0o--, -f CEJ vv o <br /> ZONING REVIEW BY: N/g- DATE APPROVED: <br /> BUILDING REVIEW BY: CQ��`�- DATE APPROVED: s' i z- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes t/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATERCONNECIION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Ycs No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: IVO C hwv <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side <br /> Rear(Street): Left Side: <br /> Adjacent Structures: tland: <br /> Building Height: Def. Hgt. P Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: I�ay: Council Approval Date: <br /> Septic: Staff Approval Date: $y: <br /> Zoning File: # Resolution: # j Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setbac : — 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 />