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- ' y CHECR OFFFORSOFF�CEIUSE ONLYOF Pffi2MITS <br /> An��ss oR r�c�: % � 1� �-��.°c�r �,��� G� psn: o�'-//�-�� 3/ v� o � <br />_ ,_ . <br /> rESCRIPTION OF WORK: ���-C'�-�'���Q'�� <br /> -------------------- --- � � � - <br /> -------------------� <br /> ZONING REVIEW BY: DATE APPROVED f Zf� �''II <br /> BIIILDING REVIEW BY: ��pe � DATE APPROVED: l l • Z���'ll <br /> ----------------------- - <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes�� Na SEWER CONNECTION <br /> STATE SURCHARGE Yes // No WATER CONNECTION <br /> INVESTIGATION FEE Yes �No PARR FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------g---- _ _ <br /> ZONING CHECR LIST Zonin District L� l�- <br /> Fire Department: �-L Post Office: /V.L School District: /V' • C • <br /> Lot Area: I'�0�D L7 t Width: S� � Depth: 2 3 F� <br /> Suxvey Submitted: Yes GC No Date of Survey: Z •ZY- 8� <br /> Droposed Setbacks : � t r <br /> Frant (Lake ) : g� Right Side: 17 <br /> Rear (Street) : Left Side: lU� <br /> Adjacent Structures : �'� Wetland: f� �ii- <br /> Building Height: Def. Hgt. ��t Peak Hgt. �I /�- <br /> Avg. Setback• � •�� Lot Coverage: D •� <br /> Exi�ting Proposed <br /> � � <br /> i?ar3cever: Q-?5 ' <br /> 75-250 ' 3°1•6`�0 ''�. 3 °10 <br /> 250-500 ' N N%1 � <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes� No Date of Council Approval: //�ZS-�( <br /> Grading: Staff Approval Date: /��� �`fi By: Council Approval Date: <br /> Septic: Staff Approval Date: f���� BY� <br /> Zoning File:# { � �}Qq Resolution # : Resolution Date: <br /> RffiKARKS (in house) : <br />