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..� . <br /> . CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE NLY <br /> � ADDRESSORLEGAL: � �Zv /,�vl�,� a�,,,�►— <br /> PID: <br /> _ DESCRIPTION OF WORK: SA��+-( -s��/t-s -r (t.�'YJ c�+-ec c�.�/'�c� v���� <br /> ZO�G REVIE�V BY: / DATE APPROVED: <br /> BUII.DING REVIE�V BY: DATE APPROVED: S"- l Z - a� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes c/ No <br /> PLAN REVIEW � Yes No t/ SEWER C0�INECTION <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 (specify) <br /> ---------------------------------------------------------------------------------------------------------------------- <br /> ZOYI�tG CI-�CK LIST Zoning District: /Ud C�-/�¢,r�t�Q <br /> � ri <br /> Fire Department: Post O�ce: School Dis[rict: <br /> Lot Area: Sq.ft. Acres Widch Depth <br /> Survey Submitted: Yes IVo Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Ad;acent Structures: Vetland: <br /> Buildin; HeiGht: Def. Hgt. Peal:Hgt. <br /> Lot Covera�e: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolu[ion Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: L.ot Coverage: <br /> Ezisting Proposed <br /> Hazdcover: 0-75' <br /> 75-250' <br /> 2�0-500' <br /> 500-1Q00' <br /> Hazdcover Variance Required: Yes No Date of Council Approval: <br /> RE1�iARKS (in house): <br /> 7 <br />