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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2 IZo C�4�2 2� r�.�� �� � �.�- <br /> PID: <br /> DESCRIPTION OF WORK: I'V �.(� 1Z�`� - <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: �o -i �-4`7 <br /> BUILDING REVIEW BY: DATE APPROVED: ( o - �� -`�l <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓' No <br /> PLAN REVIEW Yes �' No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WATERCONNECT'ION <br /> INVESTIGATION FEE Yes No �� PARK FEE <br /> SAC Yes No �/ SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: ��-�� <br /> Fire Department: (�vni b (Atc:� Post Office: School District: �3'f�i�'0 <br /> Lut Area: Sq.ft.Z/��- s t Acres Z �- Width �/f/Z�6 v v►4+(Depth — <br /> Survey Submitted: Yes �L No Date of Survey: j�' 8 " �cl <br /> Proposed Setbacks: , <br /> Front(bxice): ,5� � Right Side: S� <br /> Rear (�eet): `''1 0 � �' Left Side: 3�Z � � <br /> Adjacent Structures: /'�J(/�- Wetland: � <br /> Building Height: Def. Hgt. Z'1.5 Peal:Hgt. 3(0 <br /> Lot Coverage: /✓�� <br /> Grading: Staff Approval Date: /O- /� -��l By: d'U Council Approval Date: -" <br /> Septic: Staff Approval Date: / a - ��> � g � By: C'.�• <br /> Zoning File: #� --� Resolution: # '`� Resolution Date: <br /> Shoreland District: � <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />