Laserfiche WebLink
CHECK OFF LIST FOR ISSUAi�10E OF PERMITS <br /> FOR OFFICE USE ONLY <br /> A�DRESS OR LEGAL: Syv Q�4R 2C�T A� � <br /> PID: <br /> DESCRIPTION OF WORK: pDo, n v..> <br /> -----___—___—___-------- ---------------------------------------------------- -:--- -=------� ---- <br /> ZO.�i G REVIEW BY: � DATE APPROVED• io ► z o <br /> BUILDI�i i G REVIE`V BY: DATE APPROVED: ,o-�2 • o j <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes � No SEWER CONIVECTION <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 /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZOi�t1�1G CHE.CK LIST Zoning District: 2 R-�1'S <br /> Fire Department: Post Office: School District: <br /> L,ot Area: Sc.ft. l �t,y2Z Acres „y 5 Width � �O� Depch <br /> Survey Submitted: Yes ( No Date of Survey: (�•24-�5 <br /> Proposed Se[backs: <br /> Front (b�ce�: zz•�3 Right Side: K 3.�- <br /> Rear (Street): ��6� + Left Side: �`'�� <br /> Adjacent Structures: iv (r4 �Vetland: N �✓{ <br /> Buildin� Hei?nt: Def. Hgt. t�.�� Pea%Hgt. - <br /> Lot Covera�e: 9•� <br /> Grading: Staff Approval Date: � By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # n5 •3�3? Resolution: # Resolution Date: � • Z-S 'o� <br /> Shoreland District: N� <br /> Ava, Setback: Bluff Setback: I.ot Covera�e: <br /> E�istin� Proposed <br /> Hardcover: 0-75' <br /> 7�-250' <br /> 2�0-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REi�1ARKS (in house): <br /> � <br />