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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I Z Coo w 0 o 14 LL Au e <br /> PID: <br /> DESCRIPTION OF WORK: ( N.sto, , (=(ry is(-f_ — Pick2r�✓i-� <br /> ZONING REVIEW BY: • ,,, , DATE APPROVED: /- <br /> BUILDING REVIEW BY: jga,,A DATE APPROVED: / - 7- �9 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes / No <br /> PLAN REVIEW Yes ri No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <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: A/0 C HAN (22 <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 Side <br /> Rear(Street): Left Side: <br /> Adjacent Structures: W:tland: <br /> Building Height: Def. Hgt. Pe. Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: : : Council Approval Date: <br /> Septic: Staff Approval Date: B : <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: 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 /> 7 <br />