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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3S )0 Q IR�(5 f �J�. R.o%��J <br /> PID: C;�; i/7 �-� l•� ���.� <br /> DESCRIPTION OF WORK: (�!t� l,.,l (2,t�� <br /> ------------------------------------------------- ---------------------------------------------------------------------- <br /> ZONING REVIEW BY: � �` DATE APPROVED: �' -�3 - S� <br /> BUILDING REVIEW BY: DATE APPROVED: Z-3 - g �j <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> \ � PERMIT Yes ✓ No <br /> � PLAN REVIEW Yes �/ No SEWER CONNECTION <br /> �;` <br /> �� STATE SURCHARGE Yes � No WATER CONNECTION <br /> INVESTIGATION FEE Yes No r/' PARK FEE <br /> SAC Yes No �/ SITEINSPECTION <br /> Number of SAC Units ��Sr��� �,� O�HER (specify) <br /> _ �� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: L2-l� <br /> Fire Department: (,on�g (.4-C� Post Office: School District: U�ayrJn <br /> Lot Area: Sq.ft. $'�}�Z Acres /.3� Width �/IJL6�v�L Depth <br /> Survey Submitted: Yes t No Date of Survey: b - 13-`IS <br /> Proposed Setbacks: <br /> Front (Lake): (I 5 � �" Right Side: t�2 j' <br /> Rear (Street): /U �� Left Side: (,2` + <br /> Adjacent Structures: �� � Wetland: ptll/L <br /> Building Height: Def. Hgt. ��(� Peak Hgt. 0��� <br /> Lot Coverage: 1 `f <br /> Grading: Staff Approval Date: 0�lk- By: � Council Approval Date: <br /> Septic: Staff Approval Date: /�l /!�- By: — <br /> Zoning File: # 23�` Resolution: # `�/3,S Resolution Date: >-Z� ��� <br /> Shoreland District: �,�e 5 <br /> Avg. Setback: U,4.�.�,,,,�rC�, Bluff Setback: N 1� L.ot Coverage: �, /,� <br /> Existing Proposed <br /> Hardcover: 0-75' _!� � <br /> 75-250' 16 b2 2 f•6 B <br /> 250-500' O � <br /> 500-1000' <br /> Hardcover Variance Required: Yes No� Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />