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� CHECK OFF LIST FOR ISSU 'vCE OF PERMITS <br /> � FOR OFFICE US ONLY <br /> :�DDRESS OR LEG�L: yOflO �A�YS�� �o PID: <br /> DESCRIPTIO` OF �VORK: /77�/v <br /> ------------------------------------------------------------------ ----------------------------------------------------- <br /> ZONTi�1G REVIE`V BY: DATE APPROVED: 6� 2'�- g> <br /> BUILD�G REVIEW BY: DAT'E APPROVED: G -27 -`i s <br /> ----------------- <br /> FEES TO BE CHARGED: M'sc. Fees Calculated By: <br /> PERI'�1IT Yes v No <br /> PLAN REVIEW Yes �' No SEWER CONNECTION <br /> STATE SURCHARGE Yes v No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------ ---------------------------------------------------- <br /> ZONING CHECK LIST Zoning District: �,- I Shoreland District : <br /> Fire Department: ►'Y�.P, Post Office: �M . School District: _ p/LOn��7 <br /> Lot Area: Sq.ft. �� Acres 5 a" Wi th ���i/�_ Depth <br /> Survey Submitted: Yes �_ No D e of Survey: 3-/3- 4 S <br /> Proposed Setbacks: � <br /> Front (L�ej: (o�l•Q Right Side: Z D -}- <br /> I � <br /> Rear (St�regt): Z o�,M Left Side: <br /> Adjacent Structures: �}Tn4c.�.�e.t9- Wetland: N �� <br /> Buiiding Height: Def. Hgt. 32� (v�� Peak Hgt. <br /> Avg. Setback: Bluff Setback: ot Coverage: <br /> Existing roposed <br /> Hardcover: 0-75' <br /> 75-25 <br /> 250- 00' <br /> 50 -1000' , <br /> Hardcover Vari e Required: e No Da e of Council Approval: <br /> Grading: Staf Approval Date: By: Council Approval Date: <br /> Septic: Staff ?.pproval Date: l l`�°1' �I''( BY� •w <br /> Zoning File: # �(� Resolution: t# Resolution Date: �v't 2�S'S <br /> REiVIARKS (in house): <br /> 26 <br />