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, CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> . , . FOR OFFICE USE ONLY <br />� ADDRESS OR LEGAI,: [ �CJ ��''l.°W �--1/�C(S � PID: <br /> DESCRIPTION OF WORR: `�'��D�� <br /> ---------------------- - <br /> -------------------------------- ---- -- --------_ <br /> ZONING REVIEW BY: � _ Q,�.� DATE APPROVED: � o�-`� <br /> 11 l <br /> BIIILDING REVIEW BY: � -V DATS APPROVED: S o2 S <br /> ------------------- <br /> FEES TO BE CHARGED: Misc. Fees Ca�culated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes� No SEWER CONNECTION <br /> STATE SURCHARGE Yes� No WATER CONNECTION <br /> INVESTIGATION FEE Yes No-� PARR FEE <br /> SAC Yes No� SITE INSPECTION <br /> Number of SAC Units OTHER (specif y) <br /> ---------------------------------------- <br /> ZONING CHECR LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Width: Depth: <br /> Survey Submitted: Y s Date of Survey: <br /> Proposed Setbacks : <br /> Front (Lake) : Right Side: <br /> Rear ( Street) : Left Side: <br /> Adjacent Structures : Wetland: <br /> Building Height: Def . Hgt. Peak Hgt. <br /> Avg. Setback: Lot 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 ApprovaJ.: <br /> Grading: Staff Approval�. Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: BY= <br /> Zoning Fi�e: # Resolution # = Reso�ution Date: <br /> REMARRS (in house) : <br />