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�HECK p�`F' i.�IST FOR ISSUA.NCE OF PER.�.'VIITS <br /> FOR OFFTCE USE ONLY' <br /> .A_DARESS ORLEirAL: 2�UC� C.o.�NT�S� �� ►O2_ �.Jes; <br /> Pll�: <br /> DESCRLPT'TON OF WOR.K: SrL2 .�3��-+ �2.�.wwQ'=��— <br /> ZO�IG REVIE�V BY: r---��______� pATE APPROVED: <br /> gU)ZDING R.EV]EtiV BY: D,A.TE APPROVED: �- �/ - o-7 � <br /> F`EES TO BE CHA_RGED: Misc. Fezs Catculated By: <br /> pEg1�T.IT Yes ,/ No <br /> PLAI�T REVZE`V Yes ✓ No SE�VE.R CONNECTION <br /> URCHARGE Yes No �VATERCONNECTION <br /> STATE S _�� <br /> INVESTIGATION FEE Yes No _/� PARK FEE <br /> SAC Yes Na _�� SITEINSPECTTON <br /> OTHER (s ecify) <br /> Number of SAC�Units P <br /> ZQNI�tG CHE.CK LIST Zoning Distric�: �JO G►-F�N C��. . <br /> Fire Degartment: Post Office; School District: � ' <br /> �.�or p,rea: Sq.ft. <br /> Acres idth Dep[h <br /> Survey Submitted: Yes No ate oE Survey; <br /> . ; <br /> Proposed Setbacks; ' � <br /> Front(Lake): Ri�t Side�`� , <br /> i <br /> Rear(�cree�j: L�f[5i�le: <br /> Adjaceet Structures: j �VeCland: <br /> Builuin�Height: Dei. Hgt, Peak.Hg�. <br /> L,ot Coverz�e: � <br /> � $v� vGliIICii n p:0'•'g-1 T7�[': � <br /> Gradin�. ScaFE Approv�l D�te; � � �'- <br /> Septic: S�a`i AppCQ'lal DaCe: E;�: <br /> Zoaing Fuz� R Reso?ution: n Resolu:ion Da:e: <br /> Shcrel�,.d Distr`:c;: <br /> Av�. SetbacK: Blu`f Seiback: I.otCoverage: <br /> v E�.iStso Proposea <br /> Hz�dcover: 0-75' <br /> 7�-2�Q' <br /> 2�0-SQO' <br /> ���-.'vCy�� <br /> _-�•_ �;�...'.2:C' D,'^"!r � :z� �.�..'_._ . �'0'��ril ��zn,SOVZ: <br /> ..__�C',.,. ..y_ ._ • <br /> F.E.�L�.R.T�S (in housel: <br />