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. .--. <br /> CHECR OFF I�IST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �o��J C� ��O I° ��• PID:�'n - I I7� �'� � I �C�C2 I <br /> D$SCRIPTION OF WORK: Z:�v�a <br /> -------------------- -�------=---------------------------------------- <br /> ZONING REVIEW BY: r,� DATE APPROVEU: � ' �' �� <br /> BIIILDING REVIEW BY: DATE APPROVED: � -�' �� <br /> -------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No � � <br /> PLAN REVIEW Yes ✓ No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No �' PARR FEE <br /> SAC � Yes No �`i SITE INSPECTION <br /> Ntunber of SAC IInits OTHER (specify) <br /> ----------------------------------------g---------_-----�----------- <br /> ZONING CHEQC LIST Zonin District �R'1 <br /> Fire Department: (,oN�(�rC.� Post Office: [ 1�4i°{zz,�4T�4 School District: pRANO <br /> Lot Area: Zo�u70s� �� - ��6��Width: !00' Depth: z-�� Av� �- <br /> Survey Submitted: Yes �C No Date of Survey: 32 S'S � <br /> Proposed Setbacks: � <br /> Front (�k�-: /ll�/� Right Side: �� <br /> Rear (-S�re�e�) : f 3� � Lef t Side: 3� � '� <br /> Adjacent Structures: I�"mqU�-� Wetland: p,f�1A <br /> Bui�ding Height: Def. Hgt. �t/ (�' P k H�- <br /> Avg. Setback: <br /> �Lot Cov rage: �`� <br /> E sting Prop sed <br /> Hardcover: 0-75' <br /> 75-250 ' <br /> 250-500 ' <br /> 500-1000 ' �---- <br /> Hardcover Varian Requi ed: es N Da of Counc'1 Approval: � <br /> Grading: Staff proval ate: By: Council pproval. Date: <br /> Septi c: Staf f A proval D te: BI�- <br /> Zoning File:� es �ution �: Resolu ion Date: <br /> RF.MARKS (in h nse) : , <br />