Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRE�S OR LEGAL: �y'�5 C 2ys n4c, �3 A`f /ZO A+J <br /> PID: <br /> DESCRIPTION OF WORK: �1!C[� ��5_ <br /> ZOrTi tG RE'VIEW BY: DAT'E APPROVED: i z-�b - �3 <br /> BUII�DING REV�`V BY: ,._ _ DATE APPROVED; �z- <br /> FEES TO BE CHA.RGED: Misc. Fees Calculated By: <br /> PER11�iIT Yes ✓' No <br /> pLAl�t REVIEW Yes ✓ No SEWER CO�INECTION <br /> STATE SURCHARGE Yes � No WATERCONNEC"ITON <br /> INVESTIGATION FEE Yes No ✓ PARK FEE <br /> SAC Yes �No ✓ SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> _- __�� ���.��i4 i H t_��_"L_(IR�M_�Lr.Nn,O__-"_--_�_____________ �__ <br /> ZO��ti G CH�CK LIST Zoning District: L2- �L <br /> Fire Department: Post Office: School District: � <br /> Lot Area: Sq.ft. (o,`�9 y Acres . i S Width Depch <br /> Survey Submitted: Yes pc No Date of Survey: ►0-2��0 3 <br /> Proposed Setbacks: <br /> Front (Lake): 3g.q Right Side: �n <br /> Rear (Street): �v I.eft Side: �Z-5 <br /> Adjacent Structures: �1//} �Vedand: N//'� <br /> Building Hei;ht: Def. Hgt. ��,.�S Peal:Hgt. 3�•5 <br /> Lot Cover2�e: � ,Soo sti�--r <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: /U�� By: <br /> Zoning File: # o s-��3Y Resolution: # sO6S Resolutioa Date: 10 -2?-03 <br /> Shoreland District: ��S <br /> Avg. Setback: ^t/r4 Bluff Setback: N/A I.ot Coverage: <br /> Existin� Proposed <br /> a <br /> Hardcover: 0-75 <br /> 7�-250' • '�" <br /> 250-500' � <br /> 500-1000' <br /> Hardcover Variance Required: Yes�y No Date of Council Approval: �o •2-�- `'3 ' <br /> RE�iARKS (in house): <br /> 7 <br />