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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> - . FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I y o0 C N c�R�,� I�cs�.c.� <br /> PID: <br /> DESCRIPTION OF WORK: (�oR,,�.�,�„ Q�..� o� ; �- <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING FEVIEW BY: DATE APPROVED: !-r 3• 03 <br /> BUILDING REVIEW BY: DATE APPROVED: � - �3 •d 3 <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 SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: Nv C�{�� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width 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: etland: <br /> Building Height: Def. Hgt. al:Hgt. �/o c-�-��+�+� <br /> Lot Coverage: n� L <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: #� Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Set ck: L,ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> ��, <br /> 7 <br />