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Y � � 1 <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �"7(, lVo,2T'I� C3�,o�,sn� �-0,4�1 <br /> PID: <br /> DESCRIPTION OF WORK: ��.C.KS <br /> ---------------------------------------------------- ------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: �-r g, o� <br /> BUILDING REVIEW BY: DATE APPROVED: 9-i 5-�� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes r/' No <br /> PLAN REVIEW Yes �- No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: GR-l/'} <br /> Fire Department: (�oMlJ (h(GtY Post Office: �,6-,v� C�'tQ.a� School District: p�,o r�o <br /> LotArea: Sq.ft. �'-1,°16C� Acres /•72, Width /�2�ZC`�bu�'✓� Depth <br /> Survey Submitted: Yes ,X No Date of Survey: S� �2.3'�� <br /> Proposed Setbacks: <br /> �rerrt (Lake): I SO' Right Side: �'O <br /> Rear (Street): / Z5' Left Side: 3 a <br /> Adjacent Structures: �1-�t� Wetland: �J l� <br /> Building Height: Def. Hgt. — Peal:Hgt. — <br /> Lot Coverage: (r•� <br /> Grading: Staff Approval Date: /�//yq By: Council Approval Date: <br /> Septic: Staff Approval Date: /V 1/} By: <br /> Zoning File: # c��-2b�b 3 Resolution: # �-1(o!c b Resolution Date: 7-3- n I <br /> Shoreland District: y�e S <br /> Avg. Setback U,q,2,��.rr C,t. Bluff Setback: � //F- L.ot Coverage: lo.� <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' Z�t.b Z`-(.� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No� Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />