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. <br /> , CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: //���('�;� ''�,,c�,�,� f=��' ; PID: <br /> DESCR�PTION OF WORK: 'r:.�.:=�:�-:-::�`if Jl�,at�.> f "f�c:�.t..z..,it.• %/. .-�. , <br /> ZONING REVIEW BY: ,�A,� DATE �.PPROVED: t o -��•�s <br /> BUII.DING REVIEW BY: DATE APPROVED: t o-�t-�s <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 CONNECT'ION <br /> INVESTIGATION FEE Yes No f PARK FEE <br /> SAC Yes No ..-- SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: (Z�C-I b Shoreland District : u�e s <br /> Fire Department: (Arvc, c�ic� Post Office: �N���u= School District: (�20�0 <br /> LotArea: Sq.ft. qn� I-7'Z Acres � ��� Width �li.�2.t��ut,42 Depth — <br /> Survey Submitted: Yes �C No Date of Survey: 9 -Z°r - 95' <br /> Proposed Setbacks: <br /> Front (Lake): Sa•7 Right Side: t�0� � N <br /> Rear (Street): 2'�5� � Left Side: Sp` } (� <br /> Adjacent Structures: �ll�l� Wetland: /II�A <br /> Building Height: Def. Hgt. 3�` Peak Hgt. 36� <br /> Avg. Setback: rU(u� Bluff Setback: �l�q Lot Coverage: /J�A <br />' Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' n'�� <br /> Hardcover Variance Required: Yes No pC Date of Councii Approval: <br /> Grading: Staff Approval Date: lo-Il��1S By: �� Council Approval Date: <br /> �!n G'N�� 1��:�'.i��,.v,';> {-' r-s^.l <br /> Sep[ic: Staff Approval Date: !:��� G�,� ��> ��s�Pc� By: �j.v� <br /> Zoning File: # Resolution: # Resolution Date: <br /> REMARKS (in house): <br /> 26 <br />