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' CHBCR OFFFORSOFF�CEIUSE ONLYOF PSRMITS <br /> � r J <br /> x�nx�ss oR r�c�: I�I�l� `U�a-��� P-+- -42��` Prn: �- �i; - �.� .-�� �:�. � <br /> DESCRIPT20N OF WORS: -n-��-r�� � � ��-- �� <br /> -----------------�------------- --- ----------_--------- <br /> ZONING REVIEW BY: /v �� DATE APPROVED� <br /> BIIII�DING REVIEW BY: w� DATE APPROVED: � -Z 6- �J <br /> ------------------- - <br /> FEES TO BE CHARG�- Misc. Fees Calculated By: <br /> PERMIT Yes l/�No <br /> PI,AN REVIEW Yes-7� No SEWER CONNECTION <br /> STATE SIIRCHARGE Yes �No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � PARK FEE <br /> SAC Yes No � SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------ <br /> ZON?'NC- C3ECK LIST Zoning Dist ict: <br /> Fire De�artment: Post Of�ice: School Di ric�: <br /> Lot Area : Width: Depth: <br /> Survey Submi�ted: Ye No Date o Surv v: <br /> P=o�osed Setbac:cs <br /> rront (Lake } , Rignt Side : <br /> Rear ( St�ee ) : Left ide : <br /> Adjacent St ucture : Wetian�: <br /> Building Height- Def. H t. Peak H t. <br /> Avg. Setback: Lo Coverage <br /> Exist ' ng roposed <br /> Hardcover : 0-7 ' <br /> 75-2 0 ' <br /> 250-500 ' <br /> 500-I 00 ' <br /> Hardcoves Va iance Required: Ye No D te of Council �proval: <br /> Grading: St ff Approval Date: By: Council App oval Date: <br /> Septic: Sta f Approval Date: BY= <br /> Zoning File . = Resolution n: Resolution Date: <br /> REMARKS (in house) : <br />