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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 30ct WE, -N 5 7- <br /> PID:PID: <br /> DESCRIPTION OF WORK: A-PP,r?60.1/ ?✓t 'Ja <br /> ZONING REVIEW BY: [ _e4r. <br /> DATE APPROVED: y• -a 3 <br /> � <br /> BUILDING REVIEW BY:/.„, ! DATE APPROVED: ' •7 . 0'3 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes i7y No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WA1'ERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: L2-l A <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. 505 Acres I.s") Width i Ste,CD Depth '-/Sb•7 <br /> Survey Submitted: Yes )C No Date of Survey: a-- 5-q <br /> Proposed Setbacks: <br /> Front(Lake): I 't o Right Side: 30' <br /> Rear (Street): 2 2 3' 11 Left Side: <br /> Adjacent Structures: /V//2 Wetland: /1///4 <br /> Building Height: Def. Hgt. C Peak Hgt. — <br /> Lot Coverage: G,°'lo <br /> Grading: Staff Approval Date: — By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: •y{5 <br /> Avg. Setback: N <br /> /i4 Bluff Setback: /10,4 Lot Coverage: ` 7o <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' /Q`jo - <br /> Hardcover Variance Required: Yes No_p� Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />