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• <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE NLY <br /> ADDRESS OR LEGAL: �y ca� Q�,�.,�5 �a�,v� <br /> PID: <br /> DESCRIPTION OF WORK: [:N;YU�e� /1jL�,�,�,� <br /> ZONING REVIEW BY: DATEAPPROVED: 9-8 -O� � <br /> B UILDING RET�IEW BY: DATEAPPRO[tED: � - 8-o� <br /> ��--------------------------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓� No <br /> PLAN REVIEW Yes �/' No SEWER CONNECTION <br /> STATE SURCH.ARGE Yes � _No w'ATER CONNECTION <br /> INVESTIGATION FEE Yes No ,/' PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Nzrmber of SAC Units OTHER (spec�) <br /> �--------�---�--------��---��- <br /> ZONING CHECK LIST Zoning Dist��ict: <br /> Fire Depm�tment: _ Pos Office: School District: <br /> Lot Area: Sq.ft. Acres W'idth Depth <br /> Survey Sz�bmitted: Yes Vo Date of Su��vey: <br /> Proposed Setbacks: <br /> F�•ont(Lake): 1 D � Right Side: t��� <br /> Rear(Street): (�IG Left Side: �� <br /> Adjacent Structures: Yi'etland: <br /> Building Neight Def Hgt. �-1 2 �` Peak Hgt. <br /> Lot Coverage: <br /> G�-ading StaffApproval Date: By: Council Appi-aval Date: <br /> Septic: Staff.�lppi-oval Date: By; <br /> Zoning File: + Resolution: n Resolution Date: <br /> Shoreland Dist�•ict: AlCGG'D Permii: <br /> Avg. Setback: BlzrffS back: LotCoverage: <br /> Existin Proposed <br /> Hardcove�•: 0-��' <br /> 75-�50' <br /> 2�0-.i 00' <br /> �00-1 D00' <br /> Hardcover f"ariance Required: }'es � o Date of Council Approval: <br /> REMARKS(in house): <br /> 1 <br /> 33 <br />