Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERII�IITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: (�,� ��Z.�S�� C��c <br /> PID: <br /> DESCRIPTION OF WORK: rv E w �Z,� S <br /> -----_ — _____----- ------------------------------------------�--------------�-- <br /> ZOrTi 1G RE'VIEW BY: ���� DATE APPROVED• '� �-�+ <br /> BUILDPIG REVIEW BY: DATE APPROVED; 7 - 't.o -�� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> PLAN REVIEW Yes �' No SEWER CONNEC'I'ION <br /> STATE SURCHARGE Yes v No WATERCONNECTION <br /> INVESTIGATION FEE Yes No �' PARK FEE <br /> SAC Yes No �� SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONI�tG CH�CK LIST Zoning District: (Z 2� I� <br /> Fire Department: ," l J Post Office: �,r, School District: c�fL�_�?� <br /> Lot Area: Sq.ft. Acres z� Width ��t.�„t����� Depth <br /> Survey Submitted: Yes D� No Date of Survey: 'l`►3• �+cj <br /> Proposed Setbacks: <br /> Fron[(�� 5�.(o Right Side: 5 S,� <br /> Rear(S�eet): '3 S S'� � Left Side: Z i;b � t <br /> Adjacent Structures: N/ � Wetland: � 1�� <br /> Building Height: Def. Hgt. Z9 � Peak Hgt. 3 S � <br /> Lot Coverage: N �� <br /> Grading: Staff Approval Date: 7 —LD- �t �t By: .U- Council Approval Date: — <br /> Septir. Staff Approval Date: By: � <br /> Zoning File: # --` Resolution: # Resolution Date: <br /> Shoreland District: N o <br /> Avg. Setback: Btuff Setback: L.ot Coverage: <br /> EzistinQ Proposed <br /> 0 <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RENIARKS (in house): <br /> 7 <br />