Laserfiche WebLink
� �HECK O�`F i.IST FOR ISSUANCE OF PERII�IITS <br /> • � FOR OFFICE USE ONLY <br /> ADDRE�S OR LE%AL: SC�O B� S I t� <br /> PID: <br /> ' �,�- <br /> T3ESCRIPTION OF W�RK: � <br /> ---------------------------------�------- <br /> ----------------- . <br /> ----- ---____---- ,� <br /> ZOVNG REVIE�FV SY: DATE APP�.OVED: <br /> BUILAII�IG REVIE'FV BY: <br /> � DATE APPROVED: �•c•o c� <br /> --------,�--------------- <br /> F`EES TO BE CH_A.RGED:` � Misc. Fees Calculated By: <br /> pEg�T Yes r/ No <br /> PLAN REVIE`V � Yes �/ No SEtiVER CO�TNECTTON <br /> STATE SURCHARGE Yes �/ No �VAT'E.RC�NNF,CTION <br /> INVESTIGATION FEE Yes No f/ PA.RK FEE <br /> SAC Yes No t/ STTEINSPECTION <br /> Number of SAC Units �_ OTHER (specify) <br /> ----------------------------- - <br /> ZON3I�IG CH�CK LIST Zoning District: �'' . <br /> Post Office: School District: <br /> Fire Deparcment: � <br /> '" ` ' � '�,h �� l.�:+i'�� Wid[h"�: Z Ir��� Depth <br /> L,ot Area: Sq.ft• ( � ���-r� Acres <br /> 5urvey Submicted: Yes �_ �o <br /> Date of Survey: ��fZ`'�J�� <br /> Proposed Setba�lc�:"``,, t(- r -�' <br /> Froa[�ake);' j �--' Riaht Side: �JCs <br /> `�- O <br /> t''�/; <br /> Rear(Stree[): �1 Iv4 Left Side: ��"' <br /> Ad'��P^r Crni�h1rZ�; /./I/1 Wetland: /� lf� <br /> ;w.,.,... <br /> Builclin� Height: Def, Hgt, � ��_/Peal:Hgt. ''. ' � <br /> Lot Covera�e: N � <br /> Grading: Staff Apgroval Date:'� 1��� By: /0 •3l•o.c Councll Approval Date: -- <br /> Septic: Staff Approval Date: �(� ���� �Y� �� <br /> Zoaing File: �� ��l_lG� Resolutioa: � Resolution Da[e: <br /> Shoreland District: ,,',',('� L,oc CoveraQe� � /� <br /> Avg. Secbacl�, B!uff Setback: �tl //�- � ' <br /> Ecistino Proposed <br /> Ha�dcover: 0-7�' ,�%�:,� _ (Z,`7 0''� <br /> 7�-250' <br /> 2�0-500' <br /> SCO-lOGO' <br /> �� � �e !� Da�e o:Cou�cil Apprcv�: <br /> H��eco�er Va-iance Req�.rzd: Y..� <br /> RE��L=�RIkS (in house): <br />