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C 'CK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2l SO We 3 /Z Hic-l_-S -i/Z6PID:p, -)/9 -,2,3 3q/ 007 <br /> DESCRIPTION OF WORK: GAVIAGeE 00v1✓J t T7 Oei <br /> ZONING REVIEW BY: tev62AAA.0....-- DATE APPROVED: g,' 2.5.--13 -. <br /> BUILDING REVIEW BY: ‘41' 1 , CS2 DATE APPROVED: Si".--7- r- 11,3 <br /> Misc. Fees Calculated By: <br /> FEES TO BE CHARGED: - - - <br /> PERMIT Yes.454o____ <br /> PLAN REVIEW Yes 1.1c) SEWER CONNECTION <br /> STATE SURCHARGE Yese.- - No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: to /3 <br /> Fire Department: L-00_, C.k Post Office: 60/.5 C../c.. School District: noto,v0 <br /> Lot Area: No Ct.e L Width: 2...4,3( /4vt. Depth: ZZo{ ' t <br /> Survey Submitted: Yes ,< No Date of Survey: (U- Y-k, <br /> Proposed Setbacks: <br /> Front (take-) : (,S t- Right Side: 30 / e) <br /> Rear (S-tet) : (ZS/ tt Left Side: ,v/A-c C ) <br /> Adjacent Structures: 477)4U4' Wetland: A)/14 <br /> Building Height: Def. Hgt. 0 .1< Peak Hgt. <br /> Avg. Setback: Arl6- Lot Coverage: AJ14 <br /> Existing Proposed <br /> Hardcover: 0-75 ' I ( <br /> 75-250 ' <br /> 250-500 ' 1 \ IIIII <br /> 500-1000 ' lif <br /> Hardcover Variance equired: Y. s No Date of Council Approval: <br /> Grading: Staff Appr val Dane: By: Co cil Approval Date: <br /> Septic: Staff Appro al Dated By: <br /> Zoning File:# Reso ut:on #: Res ution Date: <br /> REMARKS (in house) : \\\ - <br />