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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �y 2 S (�A�(2��J(�. i�� <br /> PID: <br /> DESCRIPTION OF WORK: �t�Rv1� - C..�-No A��t��a� >S�o �,,3,� ,�is <br /> ZO�tNG $EV�W BY: DATE APPROVED: /�-L6 -a z <br /> BUILDI�tG REVIE`V BY: Nl�- DATE APPROVED; <br /> FEES TO BE CHARGED: � � A`r� �Misc Fees Ca cu at d By G�v� �~ <br /> PERMIT Yes �/ No <br /> PL?,l�t REVIEW Yes �� No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZONIlVG CHECK LIST Zoning District: L/L-1�4 . <br /> Fire Department: Post Office: School District: � <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes� No Date of Survey: q-23-oZ <br /> Proposed Setbacks: <br /> Front(Lake): — Right Side: — � $� 1=��^- � T �'�'�"�s <br /> Reaz(Street): I.eft Side: � <br /> Adjacent Structures: — Wetland: — <br /> Building Hei;ht: Def. Hgt. Peal:Hgt. <br /> Lot Coverage: �— <br /> Grading: Staff Approval Date: — By: Council Approval Date: /�•zS-az <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Oz Zs3�t Resolution: # Resolution Date: II- 2S-o2 <br /> Shoreland District: �,�� <br /> Avg. Setback: �..i�/� Bluff Setback: �✓(•'-� Lot Covenge: <br /> EzistinQ Proposed <br /> 0 <br /> Hardcover: 0-75' ^ �- <br /> 75-250' /Vv C��� <br /> 250-SQO' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No_� Date of Council Approval: <br /> RENIA.RKS (in house): ���J �S/�'Ne�? <br /> 7 <br />