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CHBCX OFF LIST FOR I8S0AMCB OF PERMITS <br />FOR OFFICE USB ONLY <br />SHAOMOJoe^ (lA PIP«_ _ _ _ _ _ _ _ __ _ _ _ _ _ _OR LBGRLt <br />dbsoixptxor of wo <br />ZOMIWO REVIEW BTt <br />BOUDIW ««*W ■>. -----■• DATl MWOVTOl <br />DATE RPPROVEDs <br />- - - <br />fees to be CHRBCTDt <br />PERMIT <br />PLRM nwnw <br />STATE SURCHARGE <br />Misc. Fees CeXculeted Byi, <br />YesJi^.Mo^ <br />Yes Mo, <br />Yes~^ No_ <br />IMVESTIGATXOM FEE Yes_ _ Ho^E^Yes No A*** —w— <br />o£ SAC OBlt. _ _ _ _ _ _OTHER (»p«cHy) <br />SBMER CONNECTION <br />WATER CONNECTION <br />PARK FEB <br />SITE INSPECTION <br />Eoann cssot list xoning Piitneti ---------- <br />Pir* So»t offlM. School nistrlcti <br />tot Ar«ai_ik,^2a,a^^_£E. Wathi_fc2,X^_dHi_ Doptht »S3 «T>(teL <br />Siuvoy Submitted. Yei_K_ Ho_ _ Date of Survey, jr-n-^3- - - - - - - <br />sight side. ,o.. <&. <br />Reo* (street)! t-_ _ _ _ Left Sldei <br />Adjacent Structures; _ _ _ _ _ <br />Wetland; A/4f <br />Building Heights Defa Hot. 2.C * <br />Existing <br />Peak Hgta__3^ <br />R„. setback. p |< <br />Hardcovers 0-75* <br />75-250* <br />250-500* <br />500-1000* <br />a IIViKO /var <br />juo <br />Qn»r f/tusfT <br />Hardcover Variance Required! Yes_ _ No^ Date of Council Approvals <br />Gradings Staff Approvi <br />Septics Staff Approval <br />9aa«t4fl%FT <br />\ OAtet 1 / Bys/Council Approval Dates <br />o\ta.“7 V. <br />Resolutj on Resolution Dates <br />remarks (ia hooM)s 71\ <br />\y- <br />\/ -V-____________