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i <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: (..j it i+e O n )L Cir< to <br /> PID: <br /> DESCRIPTION OF WORK: k 1 TL H er_1 (2.6m oot.(— <br /> ZONING REVIEW BY: nl I A DATE APPROVED: <br /> BUILDING RE VIE W BY: -<-t�(„��1,t,�.a,-- DATE APPR O VED: 6. 141-o c, <br /> FEES TO BE CHARGED: " Misc. Fees Calculated By: <br /> PERMIT Yes .7 No <br /> PLAN REVIEW Yes I 7/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes c/ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> (yeZONING CHECK LIST Zoning District: fVO C 17V <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right S. e: <br /> Rear(Street): Left •ide: <br /> Adjacent Structures. Wetland: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: 0 11-- By: CAA— <br /> Zoning File. # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff S back: Lot Coverage: <br /> Existin 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 /> 31 <br />