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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z(� C fZYsTAL CfZ�.�K <br /> PID: <br /> DESCRIPTION OF WORK: (�cAsc:vl�'�!� ��� i S�+ <br /> -------------------------------------- -------------------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: 5• z�- a 2 <br /> BUILDING REVIEW BY: DATE APPROVED: ,S'.z 3•o z <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 WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZO1�IING CHECK LIST Zoning District: /l/v C�-fArr6� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: W land: <br /> Building Height: Def. Hgt. Pe � Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: y: Council Approval Date: <br /> Septic: Staff Approval Date: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> � <br />