Laserfiche WebLink
� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �/Z YS GNi POc�� C�Aiv e <br /> PID: <br /> DESCRIPTION OF WORK: Fi I 1 <br /> ZOrT�i tG REVIEW BY: DATE APPROVED: � / � -o Z <br /> BUII.DI�i 1G REVIEW BY: iv/.a DATE APPROVED: <br /> — — --- ------------------------J ------------------------------- <br /> FEES TO BE CHARGED: 6�`°'N5 ��VIN��`�"��lcula ed B G' J. �, <br /> isc. ees a y: <br /> PERNIIT Yes i/ No <br /> PLAi�1 REVIEW Yes No SEWER CONNECITON <br /> STATE SURCHARGE Yes No WATERCONNECITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CH�CK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Dep[h <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: �,`C <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peal:Hgt. <br /> Lot Coverage: <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 Setback: L.ot Coverage: <br /> Existing Proposed <br /> Hazdcover: 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): ��'x�n-,P�,N 6 0 ��- �a T-;-a•� d-� /L�.a�.,•a� fysrz� <br /> 7 <br />