Laserfiche WebLink
�i�C� OFF i,IST FOR ISSUANCE OF �'ERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEuAL: 2zsS �3�A�►�i� <br /> PID: <br /> . DESCR�'TION OF WORK: �r�T(�t r(�.��� ����� _ <br /> ------ --- --------------------------------- <br /> ZO�G REVIEtiV BY: � �_ DATE APPROVED: 3-Z�3 -c�� <br /> SUII,D�G REVTE�V BY: DATE APPROVED: 3 -Zt9-cti. <br /> k'EES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEtiV � Yes —� No SE�VER CO�INECTION <br /> STATE SURCHARGE Yes � No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> Z01II�G CHE.CK LIST Zoning District: Nv C�-f�4-n/� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq,ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Ri�it Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wetl d: <br /> Buildin� Heigh�: Def. Hgt. Peal:Hgc. <br /> Lot Coverage: <br /> Grading: Staff Apgrovat Date: By Council Approval Date: <br /> Septic: Staff Approval Date: B � <br /> Zonin� File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setb ck: L.ot Covera�e: <br /> Etistina Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 2�0-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REtiL4RKS (in house); <br />