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1 . � <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I gV5 priitm.k ✓L <br /> PID: <br /> DESCRIPTION OF WORK: .St-l-/ t 2 x L to <br /> ZONING REVIEW BY: _ ,QD ' DATEAPPROVED: 9-8 -� <br /> BUILDING REVIEW BY: . , I DATEAPPROVED: - tg -o$ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes L.V. No <br /> PLAN REVIEW Yes / No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> INVESTIGATION FEE Yes No ✓ PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specO) <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 .0 No Date of Survey: 0 Al I <br /> Proposed Setbacks: <br /> Front(Lake): 2.041 ± Right Side: 3,3' 4 <br /> Rear(Street): 10 0' t Left Side: r(8 t -4- <br /> Adjacent Structures: 100' l Wetland: <br /> Building Height: Def. Hgt. cy.►e Peak Hgt. — <br /> Lot Coverage: AJ)114- <br /> Grading: <br /> v4-Grading.: Staff Approval Date: -- By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: N• MCND Permit: <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 /> 33 <br />