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� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: f� t%� [������-v��..>�i �--z-�-�-- <br /> PID: ��� ' // -�13 u � o�i/ <br /> DESCRIPTION OF WORK: ,�� <br /> ---------------------------------------------------------------------------------------------------:---�--�a------- <br /> ZONING REVIEW BY: � CQ� DATE APPROVED• 'l °c b <br /> BUILDING REVIEW BY: DATE APPROVED: 8 -�3- 5 � <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes v' No SEWER CONNECTION <br /> STATE SUR��-IARG� Yes r� No WATERCONNECTION <br /> INVESTIGAT'ION-FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: �(Z� l IA <br /> Fire Departmeiit: Y{nApc,�c` PLA,nI Post O�ce: (V�n�i�e Pt,q-�N School District: p/2.c��,c� <br /> Lot Area: Sq.ft. �-1`'j,�3 Z Acres �•OZ� Width IY�I• � Depth �o�.C�Z <br /> Survey Submitted: Yes_� No Date of Survey: 9��5'- g�3 <br /> Proposed Setbacks: <br /> f ' <br /> Front (�ej: ?S :- Right Side: � SZ <br /> Rear (S�feet): 1 U�� } Left Side: N l� <br /> Adjacent Structures: L S� s►(-ecQ Wetland: �tJ �/�. <br /> Building Height: Def. Hgt. p� Peak Hgt. . <br /> Lot Coverage: �,�L <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> A, Shoreland Dist:ict: . <br /> N� Avg. Setback: Bluff Setback: L,otCoverage: <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): /-�F rClz 7�`+�= r'�4�T /�c 2 m � T ' N� pp� C.c; <br /> Fc C; N-o v►-•�ow n�e�-, <br /> 26 <br />