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� • <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �3-1 G It�::.� W �.�,q � <br /> PID: � <br /> DESCRIPTION OF WORK y�-�Q d Q p(2,�c��.5 + �2�i�,�o p L-�. 2,,,r d1 0�C <br /> ------------------------------------- --------------------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: G - � ) - o� <br /> BUILDINGREVIEWBY.• DATE APPROVED: 6 .•Z� -v� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLANREVIEW Yes_� No SEWER CONNECT70N <br /> STATE SURCHARGE Yes �/ No WATER COIVNECTION <br /> I.�IVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTIDN <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: �(1 o C�{.Dq�y,P <br /> a <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 Sid : <br /> Rear (Street): Left Side: <br /> Adjacent Structures: etland: <br /> Building Height: Def. Hgt. ak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: y: <br /> Zoning File: #{ Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setba : 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 Approval: <br /> REMARKS(in house): <br /> 32 <br />