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CHECR OFF LI�T FOR ISSIIANCE OF PERMITS <br /> " ` FOR OFFICE US� ONLY <br /> � , <br /> ADDRESS OR LEGAL: 33�15 C�fSN�C. (��1 �-QA� pID= __ <br /> DESCRIPTION OF WORR: ����-' � <br /> ---------------------------------------- <br /> ZONING REVIEW BY. _ DATE APPROVED: l!-l-�Ty <br /> BIIII,DING REVIEW BY:_ ✓vw�— DATE APPROVED: ( -(-`�� <br /> ----------------- <br /> FEES TO BE CHARGED- Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes ✓�iNa SEWER CONNECTION <br /> STATE SURCHARGE Yes �� No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------ <br /> --------- <br /> ZONING CHECR LIST Zoning District: Gle-l � <br /> Fire Department• /� ` �- _ Post Office: — School District: <br /> Lot Area: �yl6 Width: S� Depth: 7�t•Z 5 <br /> Survey Submitted: Yes� No Date of Survey: 3'"7���'( <br /> Proposed Setbacks : � <br /> Front (Lake) : ��� Right Side: 0� <br /> Rear ( Street) : �� Left Side: ��' <br /> Adjacent structures : ��/� wetland : �C/�/d <br /> Buil.ding Height: Def . Hgt. (�, ��-- Peak Hgt. U�(/t <br /> Avg. Setback: �� Lot Coverage: ��' � <br /> Existing Proposed <br /> Hardcover: 0-?S ' <br /> 75-�50 ' �17-10 Q°lo <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes � No Date of Council Approval.:_ <br /> Grading: Staff Approval Date: l��/�- By: Council Approva� Date: <br /> Septic: St�ff Approval Date: �l/� BY= <br /> Zoning File:# /S S `1 ResoJ�ution �: ���� ' - Resolution Date: �0-�g - �r� <br /> REMARRS (in house) : <br />