Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PER�IITS <br /> FOR OFFICE USE ONLY • <br /> ADDRESS OR LEGAL: 1�►S C�+s�<— c�-�—�t <br /> PID: <br /> DESCRIPTION OF WORK: N C� �.s <br /> ZOr'liti G REV�tiV BY: DATE APPROVED: �z-z�-y g <br /> BUII�DL�1G REVIE`V BY: DATE APPROYED: �2- �� -5� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> pLAN REVIERI Yes �' No SE�VER CONNECTION <br /> STATE SURCHARGE Yes `� No `VATERCOivNECITON <br /> I?�TESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZO�Z�G CH�CK LIST zoni.ng District: RfZ� �� <br /> Fire Department: (.�nr�(P�tuj Post O�ce: ��,��� School District: O f�-�� <br /> Lot Area: Sq.ft. Ilo��`�`�3�S t Acres �.(, ` Width Z�lo.lb Vk� Depth �vL�`-15 ✓�rv�t_ <br /> Survey Submitted: Yes o� No Date of Survey: ►2- `b'`�� <br /> Proposed Setbacks: , <br /> Front(Lake): S�• � Right Side: ) Qj(o } <br /> Rear (Street): �-i �c�� � Left Side: 3�� � <br /> Adjacent Structures: N �� Wetland: I�0 <br /> Buildin�Heigh[: Def. Hg�. P2alc Hgi. <br /> Lot Covera?e: �✓ �� � <br /> Gradin�: Staff Approval Date: � Z - 27�4'1 By: o��• Council Approval Date: — <br /> Septic: Staff Approval Date: �Z.-t1- 9 g By: GP• <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: /�-�0 <br /> Avg. Setback: Bluff Setback: L.ot Co��era�e: <br /> Ezisting Progosed <br /> Hardcover: 0-7�' <br /> 75-2�0' <br /> 2�0-500' <br /> 500-1OQ0' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REl�1ARKS (in house): <br /> 7 <br />