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• <br /> CHECK OFF LIST FOR ISSUANCE OF PER. IITS <br /> FOR OFFICE USE ONLY. � `�� <br /> ADDRESS OR LEGAL: 2(n S ,C DC ST <br /> PID: . <br /> DESCRIP'T'ION OF WORK: (UE,--v-3 fZ S, r _RA <br /> DATE APPROVED: A lU <br /> ZOYING REVIEW BY: 1.1. DATE APPROVED; t --7-°? � . <br /> BUILDING REVIEW BY: TWO.,. — ' <br /> •___ ------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes V No <br /> PLAN REVIEW . Yes f No _ AT <br /> SEWER CONNECTION <br /> STATE SURCHARGE Yes <br /> .� No _ WERCONNECTION <br /> INVESTIGATION FEE Yes No ----7— PARK FEE <br /> SAC Yes No --- STTEINSPECTION <br /> Number of SAC•Units Giud.,,oF.An+ente oA.,e,.4At. OTHER (specify) <br /> mooV<..)„e 12-'7 70 <br /> ZONING CHECK LIST Zoning District: . <br /> • <br /> Fire Department: <br /> Post Office: School District: <br /> •i <br /> Lot Area: Sq.ft.Lf 0(_fl I Acres I •a CA--( Width 1-7� Depth <br /> Survey Submitted: Yes <br /> No Date of Survey: -/ /7/0-7 <br /> Proposed Setbacks`. /�/(� ��xl�� ��i <br /> Front(L e): �' Righ.t •Side: • ` <br /> Rear(Set •): 10 D ':4- '{1-C°()L'�eft Side: S.(O /. 40( I 'II'''. <br /> l/ <br /> Adjacent Structures: <br /> Wetland: Kil irmD% 'I w <br /> Building Heiot: Def. Hgt. !/L- Peak Ha L/(U <br /> Lot Coverage:V (0.3°70 <br /> (3v• <br /> Grading: Staff Approval Date: $ <br /> By: o Council Approval Date: -,' <br /> -! -a'"? Y �, �-*-. 1•-:45(2- -coo-- v.-Sub.) <br /> Septic: Staff Approval Date: k)// BY: l—c <br /> 7oaing File: # N/ Resolution: n Resolution Date: <br /> Shoreland District: y-e.5 <br /> Avg. Setback: iv//Q <br /> Bluff Setback: /v //-1 Lot Coverage: up .•';°?° <br /> Proposed <br /> E istingo <br /> Hardcover: 0-75'75-2glOY IP I iqd/6 <br /> 25.050'-TUU �'u3* I S.Z-'Io <br /> 2�u <br /> 500-10C-0' �( A:7::::--..1: <br /> r fps,�Y <br /> �` Re d: ' �;� /� r_,-,are o. Cc'._-.... A:_ : .�. tVI <br /> l--I?-CCo'•;er �Vz ___... :;a�.i2;�. e� III <br /> rE1:\L'`.iRh (in hoaie): <br />