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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRF.SS OR LEGAL: Z-71� C r45 C,o (�orrv-r (Zo,�,� <br /> PID: <br /> DESCRIP'I'ION OF WORK: G�tt1��c O N - 2�� sto <br /> ZOi�TIl�tG REVIEW BY: DATE APPROVED: 9�� -5 7 <br /> BUII.,DING RE'VIEW BY: DATE APPROVED: q •� • S� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes �" No <br /> PLAN REVIEW Yes � No SEWER CONNECITON <br /> STATE SUR`HARGE Yes �/ No WATERCONNECTTON <br /> INVESTIGATION-FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONIlVG CHECK LIST Zon.ing District: C,+C-/L <br /> Fire Deparcment: ywo�tip Post Office: �uq,�,4�r. School District: c,�-P�Tt�t1c� <br /> Lot Area: Sq.ft. 1��,C�3Z .2� Acres • 31 tiVidth I Oo Depth /6 U .3 Z �i.�f <br /> Survey Submitted: Yes,� No Date of Survey: g-l3�8 S <br /> Proposed Setbacks: <br /> �ront (�.a�e'j: �f•� Right Side: 1 c�1� � <br /> Rear (S��r•eet): l 37 � Left Side: �O� '—' <br /> Adjacent Structures: Z�� '� Wetland: �! (,�} <br /> Building HeiUht: Def. Hgt. D,(c. Peak Hgt. p�JC. <br /> Lot Coverage: (�,(.� <br /> Grading: Staff Approval Date: N I� By: — Council Approval Date: — <br /> Septic: Staff Approval Date: lv l/} By: — <br /> Zoning File: # 2 Z 5'-f Resolution: # � `� �.� Resolution Date: 1 ' Z-�'S� � <br /> Shoreland DisL-ict: y�'S _ <br /> Avg. Setback: ��/� Bluff Setback: /U [A- Lot Coverage: � <br /> • Existing Proposed <br /> Hazdcover: 0-75' <br /> 75-250' . . <br /> 250-500' ' wv �f+9M� <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REI�ZA,RKS (in house): <br /> 26 <br />