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' ,. ` , <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z�U� � _ �2 , �' <br /> PID: <br /> DESCRIPTION OF WORK: s�{c_.Y� <br /> ------------------------------------------ /---- --------------------------------------------------------------------- <br /> ZO`ING REVIEW BY: �Cl DATE APPROVED: � ��-z.-�� <br /> BUILDING REVIEW BY: DATE APPROVED: —� -� z.-�� <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 Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: �/Z `t� <br /> Fire Department: ,v Post Office: �rr� (�4--t[.es School District: V 2un/1� <br /> �— <br /> /`S��t Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes� No Date of Survey: oo.r <br /> Proposed Setbacks: <br /> Front (Lake): ?�� f- Right Side: /S <br /> Rear (Street): i v0� -� Left Side: 3��` '� <br /> Adjacent Structures: (t)z)� + Wetland: <br /> Building Height: Def. Hgt. U`�C Peak Hgt. C�.(` <br /> Lot Coverage: — <br /> Grading: Staff Approval Date: — By: Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # — Resolution: # Resolution Date: TN� �T e-• ✓•�� <br /> Shoreland District: �� <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): (��c� s S��..,��J � <br /> 7 <br />