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- � CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 31�5 C�,4SC,J pID= <br /> D$SCRIPTION OF WORR: k�T'CHGN Q,�-�vt.o�p�Z <br /> -------------------------n----------------------------------------------------- <br /> ZONING REVIEW BY: ('��� (�r--- DATE APPROVffi�: �-3l)-�(Z <br /> BIIILDING REVIEW BY: DATB APPROVF.D: "1-3v��i Z' <br /> FEES TO BE GHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes� No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � PARR FEE <br /> SAC � Yes No � SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ---------------------------------------------------------------- <br /> ZONING CHECR LIST Zoning Di trict: <br /> Fire Department: Post Office: Schoo istrict: <br /> Lot Area: Width: Depth: <br /> Survey Submitted: Y s No Date o S rvey: <br /> Proposed Setbacks: <br /> Front (Lake) : Righ Si e: <br /> Rear (Street) - Left Si e: <br /> Adjacent Stru tures: Wetland <br /> Bui].ding Height: Def. Hg . Peak Hgt. <br /> Avg. Setback: <br /> � L t Covera e: I <br /> Exist'ng Propose <br /> Hardcover: 0-75 ' I <br /> 75-250 <br /> 250-500 ' <br /> 500-100 ' <br /> Hardcover Var'ance Require : es No Date of Counci Approval: <br /> Grading: Staf Approval. Da e: B : Council A proval Date: <br /> Septic: Staf Approval Dat : BY= <br /> Zoning File: Re oluti n #: Resoluti n Date: <br /> REMARRS (i honse) : , <br />