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- <br /> CHECK OFF LIST FOR ISSUANCE OF PER11�1.�TS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: _ �32► i (3��I S 1��., �2 0,�� . <br /> PID: <br /> DE.SCRTPTION OF WORK: _ Z ni�.P �`�-o(�� f4/J,�� r� �� �XO��sr��✓ Ur= �/�y�'vio�s (1.�,�:- <br /> ZONING REVIE��BY: ,� _�~_ DA'I'E APPROVED: q �-�-��~_ <br /> BUrLD .T�i TG REVIE�'Y BY: . DATE APPROVED: c, _Z -�� <br /> FEES TO BE CHARGED: � � Misc. Fees Calculated By: � <br /> PERMIT Yes t/" No ' <br /> PLAN REV�W Yes � No SEWER COVNECITON <br /> STATE S UR�H�,RG c Yes � No �AT�R CO�NECTTON <br /> INVESTIGAZTON-'�EE Yes " No �/' PARK FEE <br /> SAC Yes No SITEINSPEC'ITON <br /> Number of SAC Units �OTHER (specify) <br /> ZONING CHECK LIST " zoning Districc: N� C Hy4�/V�L N _� M <br /> Fire Deparcmenr. Post O�ce: Schovl District: � � <br /> L,ot Area: Sq.ft. Acres 1�Vidth Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (La.�Ce): . Right Sid : � <br /> Rear (Street): - Left Side: <br /> Adjacen[Structures: ti etland: <br /> Building Height: Def. Hgt. p �t�Ho�, <br /> Lot Coverage: <br /> Gradin�: Staff Approval Date: � y: Council Approval Date: <br /> Septic: Staff Approval Date: y• • . <br /> Zoning File: # � Resolution:# Resolution Date: � <br /> Shoreland Disc:ict: � � <br /> Avg. Setback: Bluff Setback L,ot Coverage: � <br /> � ' E���� Proposed � <br /> Hazdcover: 0-75' <br /> 75-250' . . � - <br /> 250-500' . • <br /> 500-1000' <br /> Hardcor•er Vuiance Required: Yes No Date oF Council Approval: <br /> � <br /> REI�ZA.RKS ('in house): � <br /> z - _ . - . <br /> • ''' 26 <br /> . �tA . . <br />