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- ' CHECIC OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR FICE ZISE ONLY <br /> ADDRESS OR LEGAL: (�� �� ����� <br /> PID: <br /> DESCRIPTION OF WORK � 2 � -z� s�v� <br /> ZONING REVIEW BY.• DATEAPPROVED: <br /> BUILDING RET�IEW BY.• 5 -z z -�g <br /> DATEAPPROVED: �-_zL_v� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By.• <br /> PERMIT Yes ✓ No <br /> P���E� Y�S � N� SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATER CONNECTION <br /> INVESTIGATION FEE Yes No_� PARK FEE <br /> SAC Yes No ✓ SITEINSPECTION <br /> Number of SAC Units OTHER (spec�) <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sg.ft. • Acres Width <br /> Depth <br /> Survey Submitted.• Yes No Date of Survey.• <br /> Proposed Setbacks: <br /> Fror�t(Lake): 1 l 5 � � Right Side: 6 7 � f <br /> 12aar Street : �j � i <br /> � � � Left Side: �d <br /> Adjacent Structures: �{� � -� - <br /> Wetland.� �j //� <br /> Building Height: Def.Hgt. 0 • K Peak Hgt. <br /> Lot Coverage: 0.k-- <br /> Grading: StaffApproval Date: /V �y4 By: Council Approval Date: <br /> Septic: StafJApproval Date: 7 ' �-(�� By: � f/�. <br /> SaL_ <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District:�,g5 MCWD Permit: <br /> Avg. Setback, o ,�� BluffSetback: D•1�– <br /> Lot Cwerage.• _ p ,�c <br /> Existing Proposed <br /> Hardcover: 0-75 <br /> 75-250' <br /> 250-500' <br /> 500-1000' �'�� <br /> Hardcover i�ariance Reguired: Yes No�_ <br /> Date of Council Approval: <br /> REMARKS(in house): <br /> 33 <br />