Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> �DDRESS OR LEGAL: C-I'� r j � �,,-�����«,a L A.v-� <br /> PID: <br /> DESCRIPTIDNOFWORK.• _ ��F�� cc�5�„ �,�,��r � �, <br /> ; <br /> ZONING REVIEW BY.• /' DATEAPPROVED: �' ,5 C� % <br /> BUILDING REf�IEW BY.• DATEAPPRDi'ED: <br /> _ 3 -lg-o� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes f No <br /> PLAN REVIEW Y�S �/' No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WATER CONNECTION <br /> WVESTIGATION FEE Yes No �/ PARK FEE <br /> SAC Yes No v SITEINSPECTION <br /> IJumber of SAC Units ��q,� OTHER (spec�) <br /> ZONING CHECg LIST Zoning District: _ � ��- <br /> Fire Departmer�t.• Post Office: <br /> School District: <br /> Lot Area: Sq.ft. • Acres s ��z.- K�idih Z / <br /> _ `fS� Depth (p � <br /> Survey Submitted.• Yes V No Date of Survey: Z -� <br /> - U 7 jQL� � '/C�-C�% <br /> Proposed Setbacks: ���F , r�l� <br /> Froni �C� � �� �ZS i L c� � ('��< fv <br /> ��'�� Side.• <br /> � �. '�y �,<n_�c Iv i,.�,�c�� <br /> . � <br /> 6�'�S � . <br /> � <br /> Rear(Stre�: � �-eft-S'ide: �j�,�� . _� f,�.;,.��..,�.y��y n<.. <br /> Adjacent Structures: �f � _ <br /> Wetland: �1«' 2� � <br /> �wl , �l <br /> Building Neight: Def. Hgt. 2 � Peak Hg2. Z{r> >�,� �S �� ��� y <br /> Lot Coverage: �/�- � 2 '�j� �(����`��.V <br /> fS <br /> Grading: StuffApprovalDate: I�G�/Ci�> B �/. zi?+��'��s�<�/bGre�'lr� i- ��.,y/"'/`� r�c����I <br /> —,--/ / Y� Counci!Approval Date: � / <br /> tU�t.N/ <br /> Septic: StaffApproval Date: ����� Bv: �.r- <br /> ZoningFile: # U�/j 33�"��' Re,solution: # ResolutionDate: � z�� C�C <br /> Shoreland District.• �� �� MCWD Permit: <br /> Avg. Setback: BluffSetback: <br /> Lot Coverage: <br /> F�isting Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 2.i 0-500' <br /> 500-1000' <br /> Hardcover 1'ariance Reguired: Yes No <br /> Date of Council.4pproval: <br /> RE111ARKS(in house): ��/-�1�<<�����(.� �r'3 ����; ��c�,l���c <br /> /G�j 2�'' -{C' S h'�'c?_� �/-�Z) �ILC'f Z1'� K - C� c- ,, ,�-, : <br /> 33 <br />