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� <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> , AUDRESS OR LEGAL: Z,rf Zq C r4 z w �Po c�v?- I�-'� <br /> PID: <br /> DESCRIPTION OF WORK: ��+-y w�,���," <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: �'�� ni ,� _ DATE APPROVED: � ��t -�"� <br /> BUILDING REVIEW BY: �, � ' ,,,_. DATE APPROVED: � -Z�c-`i ? <br /> ---------------------------------------------�- ----------------------------------------------------------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ,� No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SUR:I�ARG� Yes _� No WATERCONNECTION <br /> INVESTIGA'I'ION FEE Yes No PARK FEE <br /> SAC Y�s No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: L/:-/ � <br /> Fire Department: ,�11i1.�v ti►•'� Post Office: �i{y-v��- School District: i..�t�;±���-- <br /> Lot Area: Sq.ft. t S, S� Z Acres . 3 aS Width (�,� `�`�l �-' Depth Z s S•`�� d�Uc.r <br /> Survey Submitted: Yes '� No Date of Survey: Z -Z`'t - `�t`t' <br /> Proposed Setbacks: <br /> �r�t (Lake): _ �'i`{ � � Right Side: �(7� �= <br /> ..�ar (Street): l 3Z.� +' Left Side: (C7� �' <br /> Adjacent Structures: /�T"1�f'�Gl�t:?') Wetland: /�`j 14' <br /> Building Height: Def. Hgt. (�,�- Peak Hgt. L� k <br /> Lot Coverage: ►Z•� � <br /> Grading: Staff Approval Date: /ti �� By: Council Approval Date: <br /> Septic: Staff Approval Date: Iv ` U�- By: <br /> Zoning File: # z,z�y Resolution: # �—J�� Resolution Date: �� ��-`�-`? 7 <br /> Shoreland Dist:ict: v�S <br /> Avg. Setback: /U i �} Bluff Setback: N`� Lot Coverage: 1 Z•t%3 <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' ; (±i.c?S� v S`j.�j <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes ,� No Date of Council Approval: <br /> REMARKS (in house): <br /> � 26 <br />