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. / <br /> CHECK OFF LIST FOR ISSUANCE OF PER�ti.fITS <br /> FOR OFFICE USE ONL Y <br /> ADDRESS ORLEGAL: 2`��`� C�sW P6�N r I�� <br /> PID: <br /> DES CRIPTIO Y OF YfjORK: b'o�T i o r� -r'�°'�'�- <br /> - <br /> - ------------------------------- <br /> ------------------------------------n-------'-n-- --- <br /> - <br /> ZONIrYGREVIEt!/BY: d ll�-- D.ATEAPPROVED: 3 - 2� -o S' <br /> B Ll'ILD.tNG RE VIE YY-B Y: Dr�TE APPR O 6`E.D: � -z 3 -a S <br /> ---------------------------------------- <br /> FEES TO BE CHARGED: �Iisc. Fees Calcicf�ctecl By: <br /> PERttifIT Ye5 _� No <br /> PLAIV REVIEGV Yes ✓ No SEYYER GO�ViVEGTION <br /> STflTE SURCH.4RGE Yes—� No ZVATER CON��IECTIO�V <br /> It�IVESTIG,4TIO1V FEE Yes tVo PARK FEE <br /> SAC .Yes tVo SITE NSPECTION <br /> Nccmber•of SAC Units OTHER (specify) <br /> --------------------------------------------------------------- <br /> Z'ONIIYG CHECh�LIST Zor�ircJ Dish•ict: (_/L�I C. <br /> Post 0 ice: Sclzool District: __.. <br /> Fire Deparhnerrt: ff <br /> z3S�4r s�+oR� <br /> Lor..={rea: S t. Z b,�b2 Acres � b �Yi�ith gs .�r �s'�%zi�Depth <br /> 9•f <br /> Sccrvey Su6rnitted: Yes � No Date af Sctivey: � z- �� - by <br /> P�•opasect Setbncks: <br /> F�•orir(Lalce}: I�S � � Right Side: t i • Z.. <br /> Rea�•(Street): 3�•�6 Lefr Side: 1� �`�� <br /> f(djacent Strt�ctu�•es: N I ✓} Y�etland: � I�} <br /> Buildi+Tg Height: Def. F(gt. �5:� PeRk Kgt. 3`i <br /> Lot Coverc�ge: � I O�� <br /> Grnding: Staff�ppi'ovaf Date: 3- 2�' o� Bv: <br /> �� � Cotutcil.�l.pp�•oval Dccte: <br /> Septic: Scaff,�{pproval Dc�te: N I v4- BY� <br /> Zoni�2g File: # os-�o87 Resolutio�t: # Resolutiai Dnte: Z-Z.�j-O S <br /> Sltoreland Dish'ict: �./�PS <br /> Avg. Setbnck: V V�(-Z��C,e: Blccff Setbacic: �t!I/f Lot Covea•age: W`'� <br /> Etiistircg Proposed <br /> HRr•dcove�•: 0-75' `� � <br /> 75-250, Z�.�y <br /> 250-500, ! � � <br /> 500-1000' <br /> Hardcover Vnriarice Reqc�irect: Yes No Date of CoEuzcif Approval: <br /> RE111ARKS(in Itoccse): <br /> 31 <br />