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CHECK 01:0F LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: \L �w <br /> PID: <br /> DESCRIPTION OF WORK: ART.\,A-4- eL- �►n, is+� <br /> — <br /> ZONENG REVIEW BY: ---- N ------ DA'L'E APPROVED: _ <br /> BUILDING REVIEW BY: ,, . DATE APPROVED: 2,-2.g-01 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes V. No <br /> PLAN REVIEW Yes ,. No SEWER CONNECTION <br /> STATE SURCHARGE Yes ,/ No WATERCONNECTION <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: NO CHANGE_ <br /> Fire Department: <br /> Post Office: School District: • <br /> • <br /> Lot Area: Sq.ft. <br /> Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: • <br /> Front(Lake): Right •- <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. • gt. <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: Lot Coverage :e <br /> Avg. Setback: Bluff Se back: — ---- <br /> Ex_isting Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardccve. ba_ acce Required: Yes -- — <br /> F.E L\ S (Li hou e): — — <br />