Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 4170 / (,U675 T &/1.4nrC 12014D <br /> PID: <br /> DESCRIPTION OF WORK: 61.Am <br /> ZONING REVIEW BY: lI_.., DATE APPROVED: Z- h -d 6 <br /> BUILDING REVIEW BY: Iij�i _ DATE APPROVED: 2- -o� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes v- No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes No f PARK FEE <br /> SAC Yes No Si'1'EINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No 24 Date of Survey: Z--r_s t e 7-7 <br /> Proposed Setbacks: <br /> Front(L-ahe): sloo' ± Right Side: 101 <br /> Rear(Street): I 105 I Left Side: 2cate <br /> Adjacent Structures: i t0 Wetland: 2 1 <br /> Building Height: Def. Hgt. 0. Peak Hgt. — <br /> Lot Coverage: N (A <br /> Grading: Staff Approval Date: 6J 1 A By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: (Vt. <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 /> 7 <br />