Laserfiche WebLink
, � • CHECK OFF LIST FOR ISSUA.z'�'CE OF PERII�IITS <br /> _ FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �{,3�� �y-��P� wA C�4N� <br /> PID: <br /> DESCRIPTION OF WORK: �(lp�,� �,�.s G �—orL t c�e (Z��-� <br /> . <br /> ZOr�'G REV�ti� BY: DATE APPROVED: S-z L- o� <br /> BUII.DING REVIEtiV BY: DATE APPROV�D: <br /> <.5 d� G,., s rvo c-� P <br /> FEES TO BE CHARGED: GFU���j Misc. Fees Ca�cu�ated By: <br /> pERMIT Yes ✓ No :� <br /> pLAN REVIEW Yes No SERrER CONNEC'ITON <br /> STATE SURCHARGE Yes No WATF�tCONNEC'ITON <br /> IIV'VESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZO�G CH�CK LIST zoni.n;Districc: N� C(-r�� � <br /> Fire Department: Post Office: School District: � <br /> I.ot Area: Sq.ft. Acres Width Depth <br /> Surve;� Submitted: Yes No Da[e of Survey: <br /> Proposed Setbacks: <br /> Front (La.ke): 5�-- Right Side: � � <br /> �� <br /> Rear (Screet): � � I,eft Side: `' <br /> Adjacent Structures: Wetland: . <br /> Buildin� Heioht: Def. H�[. Peal:H�t. <br /> Lo� Covera�e: <br /> Gradin�: Staff Approval Date: �(— Z(o -c�' By:� Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: � Resolution Date: <br /> Shoreland District: <br /> Av�. Setback: Blufi Secback: LotCovera�e: <br /> E���, Proposed <br /> � <br /> Hardcover: 0-75' <br /> 75-250' <br /> ti0-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RE�LA_RKS (in house): <br /> 7 <br />