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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2350 Ui 4VZo4T KL JL PID: <br /> DESCRIPTION OF WORK: re/VC,C, <br /> ZONING REVIEW BY: 3-.7641. �- R _c . DATE APPROVED: 41-16 -6/7 <br /> BUILDING REVIEW BY: 97e(00L--- DATE APPROVED: t--/-/6- `t ( <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes VNo <br /> PLAN REVIEW Yes - No SEWER CONNECTION <br /> STATE SURCHARGE Yes V Noted WATER CONNECTION <br /> INVESTIGATION FEE Yes No I/ PARK FEE <br /> SAC Yes Noy SITE INSPECTION <br /> — <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: /VC) -- / <br /> 1 <br /> Fire Department: di Post Office: School District: --- <br /> Lot <br /> Lot Area: Width: Depth: <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks : 2 ( <br /> L-t-'01./--' 6-t-TV- Lt-v--1( -(1. (('-\,W- LD <br /> Front (-Lake : J C -I-- Might Side : <br /> Rear ( Street) : Left Side: <br /> Adjacent Structures : Wetland: <br /> Building Height: Def. Hgt. Peak Hgt. <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 Noy Date of Council Approval: 1 - <br /> �_, <br /> Grading: Staff Approval Date: L By: Council Approval Date: L" <br /> Septic: Staff Approval Date: By: <br /> Zoning File:# Resolution #: Resolution Date: <br /> REMARKS cin house) : Ai(1,,,,, L_- (1"-- ;\; <br /> /� "`( i <br /> .., '_ � y/ <br /> r, / -7 .3 / 7 -- --- 1 , , <br />