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40.- <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> • FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 220 W n o C t-t cu_ R-0,44 <br /> PID: <br /> DESCRIPTION OF WORK: 12c_v'.o Oc.7.-. <br /> ZONING REVIEW BY: N4/I DATE APPROVED: <br /> BUILDING REVIEW BY: (41,(Qii DATE APPROVED: I- 17- (.0 <br /> 9 <br /> U <br /> t'EES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes V- No <br /> PLAN REVIEW Yes 7 No SEWER CONNECTION <br /> STATE SURCHARGE Yes - No WATER CONNEC,I ION <br /> INVESTIGATION FEE Yes NoPARK FEE <br /> INSPECTION <br /> SAC Yes No <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: , Shoreland District : <br /> Fire Depart of ent: Post Office: School District: <br /> Lot Area: S i. . Acres _ Width Depth <br /> Survey Subui.tt=o: Yes No Date of S ey: <br /> Proposed Se bac •. <br /> Frost ( •'e): Right Side: <br /> Rea_ (Stree': Left Side: _ <br /> Adj acent St tures: Wetland: <br /> Building He I ght: Def. gt. Pe.< HD. <br /> Avg. Setbac <br /> Blu Setback: Lot Coverage: <br /> Exi ing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover ariance Required: Yes No Date of Council Approval: <br /> Grading: taff Approval Date: By: Council Approval Da e: <br /> Septic: St Approval Date: By <br /> Zoning F. e: # •olution: # Resolution Date: <br /> REMARKS (in house): <br />