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CHECK OFF LIST FOR ISSU.A.NCE OF PERMITS <br /> FOR OFFIC.� USE ONL�' <br /> ADDRESS OR LEG_AL: � �O �l�e Sa- � ;Q w �� <br /> PID: <br /> � <br /> DESCRIPTIOIV OF WORIi: �,',� /�C61PC /�Y/-�,QJ �f� �� � � � .Isl�vc ' �l�f,h�1S <br /> -- ----______------- ---- -------- —_____ �-'�"'''" <br /> ZONING REItIEW"B�:• � � ���'s� <br /> G�� DATEAPPROIfED: '� /G C� C <br /> BUILDINGREG'IET�'B�:• � �,,,_ DATEAPPROTrED: _y_�y-o� <br /> FEES TO BE CHARGED: Misc. Fees Calculated Bv: � �` ~ �r <br /> PERMIT �es ✓ �;o <br /> � PLAN REVIEN� Yes ✓ No SEN'ER CO.NNECTION <br /> STATE SURCH.ARGE �'es ,/ No Y�'ATER CONNECTION <br /> INVESTIG_ATI01�'FEE Yes No f PARK FEE <br /> SAC �es No � SITEII�'SPECTION <br /> Number of SAC linits OTHER (spec�� <br /> ZONING CHECIi LIST Zoning DISfPlCI� l� 2, -� �' ��� � �~+ �� � <br /> Fi��e Department: Post Ofj?ce: School Disd�ict: <br /> Z P � Acres � <br /> Lot Area: Sq.ft Ci, Y6�idth �(�� � Depth � 2�� <br /> Survey Submitted: �es No Date of Swvey: �� � �' U � <br /> P�roposed Setbacks: ��+` '=1%�h�r'�� n�,,�, <br /> o�h�nc ��+ �� , / '� -�v� racic���rm5 <br /> Front��ke): �glzt Side: �C 2 3 " .� i,�,� <br /> i�,2rz c•' u,� <br /> Rear(Sxweetj: 3 j: y' Left Side: f"1 /�- � ��. 3, �o ;`2�-v <br /> i <br /> Adjacen(Structa�res: ��� � N etland: � <� ����y��- <br /> Building Hei�ht� Def Hgt. � Peah Hgt. �L�S ��'1 C1c:1 S-� <br /> Lot Coverage: �'� � ��'�'�C��CJ��O `—' .�'�Z �� �C�"� C:��N) <br /> Gradinb StaffApproval Date: By: � �� Council App�-aval Date: <br /> Septic: StaffApprovcr!Date: �� Bv: �� <br /> ��Zor�ingFile: # �� C 'i� Resolutiori: �'� 7� _ f� i� ('� �: <br /> �� .� Resolution Date: <br /> Shorelaizd District: '���'�'� ��i hLJs�j�� G`r'uC MCYT D Permir: <br /> Avg. Setback: �/-}- Bh�Setback LotCoverage: <br /> Faisting Proposed <br /> Hardcoi�er: 0-'�' /f/� <br /> ��-'�D' � p. <br /> ��0-.i 00' ��2��U <br /> .i00-1000' <br /> Nardco»ei• I'ariance Reqzrired 3'es No Date of Coiu�cil.4pproval: <br /> REMARICS(ii� hnuse): ��S � 7C'/r!�'!/� /�r' .�?C/S��II�I', <br /> �� �Y'/��� — L ��'i�Y�i d � �Se -SL�� ,r-ta� ,� � _ <br /> �' �'�� <br /> ,1 ���:�,c �- � . <br /> » .�-C �� �2 <br /> .�� �i - b� <br /> - CO <br />