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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: d� C `f�N�� ��c,� <br /> PID: <br /> DESCRIPTION OF WORK: ^rEc� /Lt3 0.� ��tin� G--x i s%iws �✓N o�� <br /> - -- --- - —J� --- ----------------------------------------------------�`o---- <br /> ZO.�tI�Ti G REVIEW BY: C� M DATE APPROVED: S-2 �/ <br /> BUII.,DI�i 1G REV�W BY: DATE APPROVED: ,-a7-oY <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERiVIIT Yes _� No <br /> PLA��t REVIEW Yes �i No SEWER CONNEC"ITON <br /> STATE SURCHARGE Yes � No WATF.R CONNECITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC�Units r/Lr,vs �=c.t �=icv..� �,-..d OTHER (specify) <br /> ZONING CH�CK LIST Zoni.ng District: l2�-��3 <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres /•/7 Width Depth <br /> Survey Submitted: Yes_� No Date of Survey: y-Z/• 4 y <br /> Proposed Setbacks: <br /> Front (Lake): SO Righc Side: 3►.Z <br /> Rear (Street): I Z.d � t Left Side: b�i•I <br /> Adjacent Structures: N /M� `Vetland: N /Y� <br /> Building Hei�ht: Def. Hgt. Z`( Peal:Hgt. 31• 5 <br /> Lot Coverage: p•�� <br /> Grading: Staff Approval Date: 5-Z? - o�-f gy; J O , Council Approval Date: <br /> Septic: Staff Approval Date: S'�ovc_� By: <br /> Zoning File: # 0�-1•30l� Resolution: # Resolution Date: S �2�/ �o y <br /> Shoreland District: /V 0 <br /> Avg. Setback: Bluff Setback: L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-SQO' <br /> 500-1Q00' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REI�IARKS (in house): <br /> 7 <br />