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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> .ADDRESS OR LEGAL: 1 g so C�o�.,co 2✓���9 � <br /> PID: - - -- <br /> DESCRIPTION OF WORK: L�q�c.` /+cc�ss s�,/rs <br /> ZOVI�tG REV�W BY: DATE APPROVED: � - ,30-03 <br /> BLTILDING REV�`V BY: DATE APPROVED: G ��v -0 3 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PER�I�IIT Yes _� No <br /> pLAi�t REVIEW Yes _� No SEWER CONNEC"I'IO�t <br /> STATE SURCHARGE Yes r/ No WATERCONNECTTON <br /> INVESTIGATION FEE � Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZO�T�i'G CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: • <br /> Lot Area: Sq.ft. Acres � Width Depth <br /> Survey Submitted: Yes �- No Date of Survey: pN r'���.r <br /> Proposed Se[backs: � <br /> Fron[(Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacen[Structures: `Vetland: <br /> Building Hei�ht: Def. Hgt. Peal:Hgt. <br /> I.ot Covera�e: <br /> `L <br /> P' Gradino: Staff Approval Date: By: Council Approval Date: <br /> D• �. <br /> e� Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland Dis[rict: <br /> Avg. Setback: Bluff Setback: I.ot Cover�e: <br /> ExistinQ Proposed <br /> � <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council App:oval: <br /> REI�LA,RKS (in house): <br /> 7 <br />