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� <br /> • CHECK OFF LIST FOR ISSUA.�ICE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3217 G45� C� �c,c�: <br /> PID: <br /> DESCRIPTION OF WORK: g x b ►�-Q-c,l� <br /> ---------------------------------------------- ------------------------------------------------�--s��----------- <br /> ZONING REVIEW BY: DATE APPROVED• G� <br /> BUILDING REVIEW BY: DATE APPROVED: s�- � _�� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes No ��" SEWER CONNECT'ION <br /> STATE SURCHARGE Yes f No WATER CONNECTTON <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: �« rs /Vv� c.��/G(�O�-u�f/I�-�r-� <br /> � 3 O�' U c= �rt�e N o (� �q�G� /l/��L <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wetlan : <br /> Building Height: Def. Hgt. Peal:H t. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # esolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: L,ot 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 />