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Pian Review Checklist for Zoning Permit Applications <br /> Address: �lll� �� �' �.. <br /> Description Gf work: ��IVI S�n� �� `1- , e, �l► j�^"' <br /> Type of permit: <br /> Zoning review by: • 5 Date Approved: �� '�"l ' �� <br /> Grading review by: 1 v Jc11 �'� Date Approved: � <br /> Other Review, Reviewed by: Date Approved: <br /> Zonin : <br /> Zoning File#: Resolution #: Resolution Date: <br /> Lot Area: SF/AC Width: Depth: <br /> Survey Submitted? es � No Date of Survey:n �, �� <br /> ��� <br /> Existin Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Pro osed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Shoreland District MCWD Permit Received Average Lakeshore Setback Met? Bluff <br /> � Yes � No 0 N/A � Yes No <br /> C�es � No 0 Yes 0 No �/A <br /> � Permit Number: Setback: <br /> Hardcover Zones Existin Proposed Variance Requi d CUP Require <br /> 0-75' ❑ Yes No � Yes No <br /> 75-250' c,cAn (bL5 Type(s): Type(s): <br /> b aW <br /> 250-500' ��� Zoning File#: Zoning File#: <br /> 500-1000' Resolution #: Resolution#: <br /> �; � � �3c�I s� 1,d25.S� _ 'g3�S�� 9�o14b•g = �$°10 <br /> Created: March 29,2011 <br /> z:\forms\plan review checklist for zoning permit applications.docx <br />