Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERII�IITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS ORLEGAL: Z.1 �•5 cr,�z�a�.��•,�:, t��= <br /> �'ID: � <br /> DESCRIPTION OF WORK: +Q c:�c_;L <br /> ZOr'I�G REV�`V BY: DATE APPROVED: � -2.i —vo <br /> BUILDiti'G REV�tiV BY: DATE APPROVED: Go •z-� `�v <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> PLAN REVIEW Yes ✓' No SERTER CONNECI'ION <br /> STATE SURCHARGE Yes �/ No WATERCONNEC"ITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZOi�iI�.�iG CH�CK LIST Zoni.ng Districc: Jv v c�+R�� <br /> Fire Deparcment: Post Office: School Disuict: <br /> I.o[Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Fron[(Lake): Right S' e: <br /> Rear (Street): Left Si : <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peal:Hgt. <br /> Lot Covera�e: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolu[ion: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff e[back: Lot Covera�e: <br /> Exist' g Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' � �S'� <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RENIA.RKS (in house): (,o�,,., (��- ✓1-e c,c`- �5 /+ /�to� —c=r�C�'���'`� <br /> 7 <br />