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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I Z?v W i LAO v�ST <br /> PID: <br /> DESCRIPTION OF WORK: <br /> ZONING REVIEW BY: DATE APPROVED: y- w -a Ar'BUILDING REVIEW BY: 1:pfr,t,...„,„ <br /> ( DATE APPROVED: y-- _o <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes 1/ No <br /> PLAN REVIEW Yes z/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes L" No WA I ER CONNECTION <br /> INVESTIGATION FEE Yes No cl PARK FEE <br /> SAC Yes No ti SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: Aid C (1-x-e <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 Sid : <br /> Rear (Street): Left Side: <br /> Adjacent Structures: etland: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setbac : 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 />