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� CHECR OFF LIST F�R ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRRSS OR LEGAL: ��13 C•R'115�¢L �la4GL- �'ID= <br /> DESCRIPTION OF WORR: f��'�'t'O���- � SN��� � ONC.� <br /> -------------------------- <br /> ----------�----- <br /> ZONING REVIEW BY' N��/4' DATE APPROVED: 1/• Z 3'S3 <br /> . <br /> BIIILDING REVIEW BY: � 1.��"'�- DAT$ APPROVED: /�` Z3'S ?J <br /> ----------------- - ------ <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 WATER CONNECTION <br /> INVESTIGATION FEE Yes No v�" PARK FEE <br /> SAC Yes No �� SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------- <br /> ZONING CHECR LIST Zon ng District: <br /> Fire Depar ent: <br /> ost Office c ool. District: <br /> Lot Area: Wi th: Dep h: <br /> Survey Sub itt d: Yes o Date of Survey: <br /> Proposed S tba s: <br /> Front (Lak ) : Rig t Side: <br /> Rear (Stree ) : Lef Side: <br /> Adja ent Str ctures: Wetl nd: <br /> BuiJ.ding eight: ef . Hg . P k Hgt. <br /> Avg. Setb ck: Lot Cove age: <br /> Existi g Propo ed <br /> Hardcove : 0-75 ' <br /> 75-250 ' <br /> 50-500 ' <br /> 5 0-1000 ' <br /> Hardcove Variance Req ' re : Ye N Date of Council pproval: <br /> Grading: Staff Approval Da e: By: Council Appr vaJ. Date: <br /> Septic: taff Approval. D t : BY= <br /> Zoning F le:# solut on #: Resol.ution D te: <br /> REMARRS (in house) : <br />