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- � <br /> , ` <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2l 7� C q sw f�oi.vr /1,� <br /> PID: <br /> DESCRIPTION OF WORK: _�,pd,n o� �%t3"wwA�1. <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> Z0�1ING REVIEW BY: � DATE APPROVED: q -S-o�. <br /> BUILDING REVIEW BY: DATE APPROVED: g . 7-o Z <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATERCONNECTION <br /> INVESTIGATION FEE Yes No c� PARK FEE <br /> SAC Yes No �/ SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. 1`-� , 0 6`► Acres . 3 2 Width � $. 2`6 Depth I �5�S�( <br /> Survey Submitted: Yes_� No Date of Survey: 7 • 2� • S�S <br /> Proposed Setbacks: <br /> Front (1c�dce): 3Z.� Right Side: �� <br /> Rear (St�eet): �2 5 Left Side: �(,� <br /> Adjacent Structures: �//f#- Wetland: N I,a <br /> Building Height: Def. Hgt. 2 5• 5 Peal:Hgt. 3� <br /> Lot Coverage: �`{•�(o <br /> Grading: Staff Approval Date: i'V I/� By: — Council Approval Date: <br /> Septic: Staff Approval Date: N 1�A By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: y-PS <br /> Avg. Setback: N 1/;- Bluff Setback: N/,i} Lot Coverage: /v I� <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' 2 3.`'7� <br /> 500-1000' <br /> Hardcover Variance Required: Yes No L. Date of Council Approval: <br /> REMARKS (in house): �/��� 2 0,- O�s �-N�S A s r-rts Pca..� `�(� <br /> NIA�T`til.-1 PS /� Sv2u-C�., O�t l=� �. � (�•��> 7'21 - °�� <br /> 7 <br />