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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �5�� c�������� <br /> PID: <br /> DESCRIPTION OF WORK ����,�, ���,,.,�,��—� <br /> ZONING REi�IEW BY.• r� DATEAPPROVED:+s� <br /> BUILDING�VIEW BY.• � DATEAPPROT�ED: �/-��_c,� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: � <br /> PERMIT Yes_1� No <br /> PLAN REVIEW Yes_�� SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECTION <br /> WVESTIGATION FEE Yes No� PARK FEE <br /> SAC Yes No �SITEINSPECTION <br /> Number of SAC Units OTHER (spec�) <br /> ZONING CHECIC LIST Zoning District: p <br /> Fire Department: Post�ce: School District: <br /> Lot Area.• Sg.ft. Acres idth 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: Wei nd: <br /> Building Height.• Def. Hgt. Peak gt. <br /> Lot Coverage: <br /> Grading: StaffApproval Date: By: Council Approval Date: <br /> Septic: StaffApproval Date: By•�� <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: MCWD Per-mit: <br /> Avg. Setback: B1uffSetback: LotCoverage: <br /> Fxisting Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover I�ariance Reguired: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 33 <br />