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- � CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �"� ,' PID: • <br /> DESCRIPTION OF WORR: i4/•�iD�T70/�/� IW��' ST"IL.fC�/�GC' /���-�`i-t,�/� <br /> -------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: (fl'Z Y"� <br /> BIIILDING REVIEW BY:_�P DATE APPROVED: G�-K~� <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 WATER CONNECTION <br /> INVESTIGATION FEE Yes No �^ PARK FEE <br /> SAC Yes No �� SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------ <br /> ZONING CHECR LIST Zoning District: L -(C <br /> Fire Department: J Post Office: ✓��� Schoo� District: ��C. <br /> Lot Area• . 5 3 ��u-s Width: � V c. � Depth: 2.� � "4' <br /> Survey Submitted: Yes ` No Date of Survey: y' �'y3 <br /> Proposed Setbacks: , � r <br /> �� (Lake) : S-`� '� Right Side: "~' <br /> &exr (Street) : N��' Lef t Side: N�/� <br /> Adjacent Structures: /�-PT1P•u�-� Wetland: /� �� <br /> BuiJ�ding Height: Def . Hgt. o -lL Peak Hgt. <br /> Avg. Setback• (���� Lot Coverage: ( �.�--/a <br /> Existing Proposed <br /> xardcover: 0-75 ' �-(2.?is`�6 �y , g°�o <br /> 75-250 ' Z1 . � �� �� ��� <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes p� No Date of Council Approva]�: �o ��Y`g3 <br /> Grading: Staff Approval. Date: (0'23'S By:� Council Approva� Date: <br /> Septic: Staff Approva7� Date: BY= <br /> Zoning File: # (�Z1 Resolution # : ���' �� Resol.ution Date: C�'1 y'�� <br /> RFMARKS (in house) : , <br />