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� <br /> . <br /> • r ' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 22�5 ►�f3����� ^� u� �4 k <br /> PID: <br /> DESCRIPTION OF WORK: (1-�-�w�� <br /> ZONING REVIEW BY: N I�- N DATE APPROVED: <br /> BUII.DING REVIEW BY: DATE APPROVED: �z- t ) -S �' <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ,/ No <br /> PLAN REVIEW Yes � No SEWER COrfNECTTON <br /> STATE SURCHARGE Yes // No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTTON <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECB LIST Zoning District: �jv Ghl'��tFa•Q <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�ide: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetl d: <br /> Building Height: Def. Hgt. Peak 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: <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 /> REMARI�S(in house): <br /> 7 <br />