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CHECK OFF LIST FOR ISSL'ANCE OF PERMITS <br /> FOR OFFICE USE ONL Y <br /> ADDRESS OR LEGAL: ��5 G�(�y�rL� P�1 tx <br /> PID: <br /> DESCRIPTIOIV OF WORK: 1<.-rc,d�o..> ,'�,vv��,p�L <br /> ZONING REVIEW BY.• N I✓� DATEAPPROVED:��� ^ <br /> B UILD�NG RE[�IEW B Y: `,Q (Q�. DA TE APPRO[jED: , o-t u-o� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: �~~ ~�� ���__ <br /> PERMIT �es ✓ No <br /> PLAN REVIEW Yes � .�Io SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No Y�ATER CONNECTION <br /> INVESTIGATION FEE Yes No ,� PARK FEE <br /> SAC Yes No �/ SITEINSPECTION <br /> Number of SAC Units OTHER (spec�J <br /> _-----------------__----------- <br /> ZONING CHECK LIST Zoning District: NU C'(t�� <br /> Fire Departmerzt: Post O�ce: School District: <br /> Lot Area: Sq ft. Acres GG'idth Depth <br /> Survey Submitted: }es No_ Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear(Sti•eet): Left Side: <br /> Adjacent Structures: W tland: <br /> Building Height: Def Hgt. eak Hgt. <br /> Lot Coverage: <br /> Grading: StaffApprovalDate: Br: CouncilApprovalDate: <br /> Septic: StaffApprovaJDate: � gy: ��� <br /> Zoning File: � Resolution: # Resolution Date: <br /> Shoreland District: MCYT'D Permit: <br /> Avg. Setback: Blzrff Setbac-: Lot Coverage: <br /> Ezisting Proposed <br /> Hardcover: 0-%�' <br /> 7.i-'.i D' <br /> ��0-.i 00' <br /> .i 00-1000' <br /> Hardcover G"ariance Regirired: }'es No Date of Council.4pproval: <br /> REM.4RIiS(in house): <br /> 33 <br />