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� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z.b 3 J Cov,•,�-rt-z�r s�D c (J� <br /> PID: <br /> DESCRIPTION OF WORK: rJ�L <br /> ZONING REVIEW BY.• t� ~ DATEAPPROI�ED:� �� � <br /> BUILDING REVIEW BY: DATEAPPROVED: �o - s-07 <br /> -------_--_----------- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes� No SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATER CONNECTION <br /> INVESTIGATION FEE I'es No_� PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ---------------------------- <br /> ZONING CHECK LIST Zoning District: �U �� <br /> Fire Department: Post Office: chool District: <br /> Lot Area: Sg.ft. Acres Width Depth <br /> Su�vey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Firont(Lake): Right Side: <br /> Rear(Street): Left Stde: <br /> Adjacent Structures: Wetland: <br /> Building Height: Def Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: StaffApproval Date: By: Council Approval Date: <br /> Septic: StaffApproval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland DisU�ict: CWD Pei-mit: <br /> Avg. Setback: BluffSetback.• LotCoverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-?50' <br /> 250-.i 00' <br /> .i 00-1000' <br /> Har�dcovei� Variance Required: Yes No D te of Council Approval: <br /> REMARKS(i��house): <br /> 33 <br />