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. .� <br /> ' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I�10 co C'�O 1-Er� s �Po� nr i R-��-✓� <br /> PID: <br /> DESCRIPTION OF WORK: A��,n o� <br /> ---------------------------------------- ------- --------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: �' •Z`i • 9�' <br /> BUILDING REVIEW BY: DATE APPROVED: g -z'� - �`� <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 WAT'ERCONNECTION <br /> INVESTIGATION FEE �9�:'Yes ✓ No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: Lh"1� <br /> Fire Department: ,v (iiic.� Post Office: �,o.�� �k�c.-� School District: C�(LvN � <br /> .��— <br /> Lot Area: Sq.ft. /vo ctf/�c� Acres — Width — Depth — <br /> Survey Submitted: Yes_,� No Date of Survey: [0 -(l�• �"� d� ��'�- <br /> Proposed Setbacks: <br /> Front(Lake): 55� Right Side: � ►S� * <br /> Rear(Street): �.3� Left Side: I 5 � <br /> Adjacent Structures: A'�T��h-t�"�'� Wetland: N I/-� <br /> Building Height: Def. Hgt. � ��� Peak Hgt. — <br /> Lot Coverage: Q C t-r�v <br /> Grading: Staff Approval Date: �' By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # — Resolution: # Resolution Date: � <br /> Shoreland District: Nv <br /> Avg. Setback: Bluff Setback: L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): � ��l.a 5e d c-�`�•'^-��� c� ��}n�T f�-e�,,.� , r <br /> 7 <br />