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� CHECIi OFF LIST FOR ISSUA��TCE OF PERl�1ITS <br /> FOR OFFICE USE ONL.Y . ' . <br /> �}�kESS OR LEGAL: Zc�s c� C��,� , s� o� <br /> PID: <br /> DE,SCRIl'T�ION OF�ORK: e �rc <br /> . <br /> ZOtiZ�'G REVIE��BY: DATE APPR�V�D: 5 � L�i� �t <br /> BUZLDIti'G REVIE�V BY: _ D�.TEAPPROYED: � - Z`��-v i <br /> FEES TO BE C�i4RGED: Niisc. Fees Calcuiated By: <br /> pEg�'r Yes �/' No �� <br /> PLAN REVIEW Yes �' No SE�TER CO�tNECTION _ <br /> STATE SURCHARGE Yes � No �TATERCONNECITON <br /> Ii�iVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes � No SITEINSPECITON <br /> Number of SAC�Units OTHER (specify) <br /> ZO\Z�IG CH�CK LIST zoni.n�Districr. R tZ -I.� _ . <br /> Fire Department: (e�_�(}�� Post•Ofuce: nr s School District: �-+������ � <br /> L.ot Area: Sq.fr. Ivv C k�rd�r�-- Acres — � R'idch -- Depth � <br /> Surve;� Subritted: Yes oC No Date of Survey: �U - `1 " c7 � <br /> �N � �e� <br /> Propased Setbacks: , <br /> Front(Lake): Z `� v Ri�ht Side: � SS <br /> Rear (Screet): S�� Left Side: 1 ��1 — <br />� Adjacen[Structures: i4TrALt-E�c,� tiVetlzs:d: N I (�' • <br /> Buildin� Hei�ht: Def. H�t. — Pe��H�t. <br /> Loc Coverage: — <br /> Gradin�: Scafi Approval Date: — By: Council Approval Da[e: <br /> Septic: Staff Approval Dace: — By: <br /> Zonin� File: R � Resolution: � Resolucion Date: � <br /> Shoreland District: /�v <br /> Av�. Setback: Btufi Setback: LotCocera�e: <br /> E���� Proposed <br /> Hardcover: 0-7�' -------- <br /> 7�-250' ---- <br /> ti0-500' <br /> 500-I000' <br /> Hardcover Variance Required: Yes No Dace of Council Aoproval: _________ <br /> REI�IA.RT�;,S (in house): <br /> 7 <br />