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. '� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> , FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3ZZ�C C/�s� C�2 e.�.�. <br /> PID: <br /> DESCRIPT'ION OF WORK: fZ���e� -n o�J <br /> ZO.�tPTi G REVIEW BY: DATE APPROVED: /v-Z d -�3 <br /> BUII.D�1G REV�`� BY: DATE APPROVED: !� -�-f9-�3 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/ No <br /> PLAi�t REVIEW Yes c/ 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 /> ZONING CH�CK LIST Zoning District: L2 -/L . <br /> Fire Department: Post Office: School District: � <br /> Lot Area: Sq.ft. 7�, ��� Acres .y 10 Width Depch <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Se[backs: , <br /> Front(Lake): f�{� � Right Side: �{U� �- <br /> Rear (Street): st►� � Left Side: 2�� T <br /> Adjacent Structures: �/ f da- `Vetland: N(/� <br /> Building Height: Def. Hgt. p.�� Peak Hgt. � <br /> L,ot Coverage: <br /> Grading: Staff Approval Date: ,�/'/'G By: Council Approval Date: <br /> Septic: Staff Approval Date: ��/�- By: <br /> Zoning File: # v 3- 2g 5 2- Resolution: # Resolution Date: !�-L7-.�3 <br /> Shoreland District: .��25 <br /> Avg. Setback: ��p„2„�Gt: Bluff Setback: I.ot Covenge: <br /> Eusting Proposed <br /> Hardcover: 0-75' -� - � <br /> 75-250' �3.z <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes�_ No Date of Council Approval: �d -2?`D <br /> REMARKS (in house): _ <br /> 7 <br />