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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY � <br /> ADDRESS OR LEGAL: /�� S GOx �-AR r� 20/� <br /> PID: <br /> DESCRIPTION OF WORK: /�sL v►�►.�.�vr 1=�N�s/-� <br /> ZOVIPiG REVIEW BY: DATE APPROVED: � -�}-4`'r <br /> BUII.DI�1G REVIEW BY: DATE APPROVED: �} -�0 -4 Q <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> PLAN REVIEW Yes �' No SEWER CONNECTION <br /> STATE SURCHARGE Yes J No WATERCONNECITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC-Units OTHER (specify) <br /> ZO�tING CHE.CK LIST Zoning District: /Uc� C�-+���,E <br /> Fire Department: Post O�ce: School District: <br /> L,ot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right S' e: <br /> Rear (Street): Left Sid : <br /> Adjacent Structures: etland: <br /> Buildin�Height: Def. Hgt. eak Hgt. <br /> Lot Covera;e: � <br /> Grading: Staff Approval Date: y: Council Approval Date: <br /> Septic: Staff Approval Date: y: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Av�. Setback: Bluff Setback L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 2�0-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />