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' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONL Y <br /> ADDRESS OR LEGAL: „7 t rt j (..� ,- �-� S [A�c-1 <br /> PID: <br /> DESCRIPTION OF WORK: ���,���, i�i i , , u -�, <br /> , <br /> ZONING REVIEW BY.• DATEAPPROVED: I Z, ►� CT�f <br /> BUILDING.itEVIEW BY.• DATEAPPROT�E'D: <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes No 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 Off ce: School District.• <br /> Lot Area: Sg.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: StaffApproval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: /,�f� �Q� By. LJ Z'' <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: MCWD Permit: <br /> Avg. Setback: BluffSetback: LotCoverage: <br /> Fxisting Proposed <br /> Hardcover: D-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover I�ariance Regui�-ed: Yes_�No Date of Council Approval: �� �Z• �� <br /> REMARKS(in house): G(�� E-�i�t►'C� Cu-c.✓' 1//bYl/�vl�.¢.� � � -� 3 �_ <br /> 33 <br />