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i <br /> l <br /> � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE O��ZY <br /> ADDRESS OR LEGAL: y,3SS C M�PPEWA C.rqN G <br /> PID: ' <br /> DESCRIPTION OF`tiORK ���F,�; <br /> ZONING REVIEW BY: DATE APPROVED: /- g-0 Y <br /> BUILDING REVIEWBY.• DATE APPROVED: /� b •o y <br /> --, <br /> FEES TO BE CHARGED: Misc. Fees Calculared By: <br /> PERMIT Yes �/ No <br /> PLANREVIEW Yes �/ No SEWER CONNECT70N <br /> STATE SURCHARGE Yes �/ No jVATER CONNEC770N <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. S.t2 --sAcres Width Depth <br /> Survey Submitted: Yes �- No Date of Surve�•: _�•ZZ .D4 �oN 1���� <br /> Proposed Setbacks: <br /> Front (Lake): Z y 0 � ± Right Side: �o ` '= <br /> Rear (Street): 3�y� z Left Side: i � �{ <br /> Adjacent Structures: (6 0 ' # Wetland: N/A <br /> Building Height: Def. Hgt. �� ' Peak Hgt. 2 Z.' <br /> Lot Coverage: N�I� <br /> Grading: Staff Approval Date: '� By: Council Approval Date: <br /> Septic: StaJ'f Approval Date: '" By: <br /> Zoning File: !i " Resolution: # Resoluran Date: <br /> Shoreland District: N � <br /> Avg. Setback: Bluff 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 Dare of Council Approval: <br /> REMARKS(in house): <br /> 32 <br />