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CHECR OFF LIST FOR ISS CE OF PERMITS <br /> � r OR Or r ICr. USE ONLY <br /> P.DDRESS OR LEGAL: y J O S f'9 I � * - PID: <br /> DESCRIPTION OF WORR: N�� � S <br /> _______________________%____________- <br /> ----------------=--3------------- <br /> ZONING REVIEW BY: DATE PROVSD: ' � 9 - <br /> 3III.I+DING REVIEW BY: <br /> DATB PROV�: 6 ' Z�.�3 - <br /> ------------ --------- <br /> FEES TO BE CHARGED• Misc. Fees Ca�cul.ated By: <br /> PERMIT Yes ✓� No - <br /> PLAN REVIEW 'Yes—� Nb SEWER ONNECTION <br /> STATE SIIRCHARGE Yes� No WATER ONNECTION <br /> INVESTIGATION FEE Yes No� PARK F E <br /> SAC � Yes No v SITE I SPECTION <br /> Number of SAC IInits OTHER specify) C1�tR/4 L� <br /> -------------------------------------------- ---------------------------t--- <br /> ZONING CHEGK LIST Zoning Di trict: G�`�� <br /> Fire Department: /1�1k[t,� �GA��ost Office: School District: R�rv�fl <br /> � t(� �--� <br /> Lot Area:�a��3� �3.2t A�S�idth: I 0 � Depth: �.�' <br /> Survey Submitted: Yes C, No Date of Sur ey: {�•L�4- S3 <br /> Proposed Setbacks: � v�f �o <br /> Front (�a�ce) : `1� ± Right Side: 4�4� ZZ '� Z � <br /> � -� Left Side: I� . }l W - � ZS•� P�' �a�2 <br /> Rear (Str-eet) : Z� . <br /> Adjacent Structures : /(���" W tland: N�� <br /> Building Height: Def. Hgt. `LZ• S Peak H <br /> � ZS• S <br /> r,vg. Setb ck:_ Lot Co erag . <br /> Existi Prop sed <br /> Hardcover 0-75 ' <br /> 5 50 ' � <br /> 50-5 0 ' <br /> 5 0-1000 ' <br /> Hardcove Varian e Require : Yes No ate of Coun '1 Approval: <br /> Grading: Staff App oval Da e: By: Council A proval Date: <br /> Septic: taff Appro al Dat : 6 � 2�� � ' BY `�� �'�'`J <br /> Zoning ' le-� R solution Resolution Date: <br /> RFI�SARKS (i.n house) : <br />