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CHECR OFF LIST FOR ISSIIANCE OF PF.RMITS <br /> FOR OFrICE USE ONLY <br /> P.DDRESS OR I,EGr'1L: �Z!'� C! 7 _�PID: � <br /> t%)i:rl%/�mG�L'L- _ . <br /> DESCRIPTION OF WORR: /9G�� ' <br /> ------------ ------------------- <br /> Z ONING REVIEW BY- �.--. DATE APPROV$D: 5- Z^S -`i 3 - <br /> 3IIII.DIZ�G REVIEW BY: _����`�.�-.- DATS APPROVED: <br /> y-Lq 5 '� _ . _ <br /> --=---------------- -------- <br /> ��S � B$ ��. Misc. Fees Ca1cul.ated By: <br /> PERMIT Yes � No � � <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SIIRCHARGE Yes �`` No WATER CONNECTION . <br /> INVESTIGATION FEE Yes No �--�""' PARK FEE <br /> SAC � Yes No �'� SITE INSPECTION <br /> Number of SAC IInits OTHER ( specify) <br /> ------------------------------------------ <br /> ----- <br /> ZONING CHECK LIST Zoning District: L����-� <br /> Y� School. District: c,�,-� 5���''�� <br /> Fire Department: y1/�(jv.�c� Post Office:(.t/�'Y�✓�"✓ <br /> � Lot Area: /?�/ 7� Width:_ `�� r 1��� Depth: GS �`� _ <br /> Survey Submitted: Yes�_ No Date of Survey: r7 - L' � `'' <br /> Proposed Setbacks : i t <br /> ��t- (Lake) : ��U � Right Side:_�_ . <br /> ��� � ���- ) ; j�./(, �a� �- Le f t S i d e: � W <br /> � P.djacent Structures : ��` � Wetland: /�/��/4 <br /> ; � 3 Z,� <br /> � BuiJ.ding Height/•�� Def . Hgt. 2� r � Peak Hgt. <br /> � � (°!l�(,��{'T VAflSA aC� '-v(� 3 S'b�'W�f �N y?Z 1r� O�" ft•L�ti� �J� Z�Z <br /> � t,vg. Setback- (1���'�� � Lot Coverage: <br /> � Existing Proposed <br /> : � f �1'. 9 <br /> fiardcover: 0-75 /� y <br /> >�73 �-. <br /> � 75-250 ' Z°I•'`� `"' � 4 <br /> � 250-500 ' <br /> � 500-1000 ' <br /> Hardcover Variance Required: Yes�_ No Date of Council Approval: `�' <br /> 2?-�3 <br /> ; Grading: Staff Approval. Date: �ff/� BY= Council Approval Date: <br /> , Septic: Staff Approval Date: N��� BY= <br /> :;_> � �i Resolution Date: Y' L �"" �-� <br /> � Zoning File:� lff5� Resol.ution � : . <br /> REMARKS (in honse) : <br />