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<br /> ' ORBS8 OR LSGAI. DBSCRIPTION s _7 /'� �C.� �� G?7t✓1��� �
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<br /> DESCRIPTZOIq OF MOR1C i ��� Y'` �-,r � �' ,,'s, r ;�,r' (�^� . � ";i;' � r j n t�::t` /��r+r t'»l't 4�
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<br /> S011IBG RSVIEIf BYs--��� ' r-��- --I �_, DATS�APPROV�Ds-----�'L`f''�`7---------
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<br /> BOILDII�IG RBNISII BY i ` DATB 11PPRO�VED t L' ` I C� '-���
<br /> PERltZ? I SS08D BY s DATB s
<br /> ------------------------------ ----�-------------
<br /> ------------------------------- ;
<br /> pggS Tp gg CgARGEp: Miec. Fees Calculated By:�
<br /> PERMZT Yes � No SEWER UNIT $
<br /> PLAN REVIEW Yes �/ ( No SEWER CONNECTION '--
<br /> STATE SURCHARGE Yes � No WATER CONNECTION
<br /> PENALTY Yes � No PARK FEE
<br /> SAC Yes No �'' SITE INSFECTION
<br /> OTHER (specifyl �
<br /> --------------------------------------------------------------------------------
<br /> ; .,-,.
<br /> �ONING CSECIC LIST Zoning District: t�- �„ - ; ^�
<br /> Fire Department: � � �-- � Post Of f ice: ��1% �� `' '� School District: -r�!�'�1��•� �'__
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<br /> Lot Area: �' � �' Width: - Depth: ` `� �`
<br /> Survey Submitteds Yes ✓ No Date of Survey: �� � � /� C
<br /> Progosed Setbncks:
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<br /> �Sr,aa.� (Lake) : - '� Right Side:
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<br /> Resr (Street) : � -� " Left Side:�' �� -
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<br /> Ad jacent Structures: �"�� �� wetland: "�""""""' '
<br /> Existinq Proposed "`r`
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<br /> Hardcover: 0-?5' �� � , �,; t�
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<br /> Sardcover Variance Required: Yes No '/ Date ot Council Approval: �--------
<br /> _. .--...._..... �`-.....� ----- .....
<br /> Gradings Staff Approval Date� � 'By.{�„ Cciunc.il 1�pproval Date:
<br /> Septic: Staf f Approval Data: ------------;-BY s ------
<br /> Zoninq Pilss� Resolution As Reeolution Date:
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