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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR,OFFICE USE O�Y <br /> ADDRESS OR LEGAL: _�� � � ? ���--t--T, ��- <br /> PID• CJ`,� - ,�.1 f�� _ <br /> DESCRIPTION OF WORK: A��p �n o� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: �-L�{ �� <br /> BUILDING REVIEW BY: DATE APPROVED: y• z Y-�� <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 � PARK FEE <br /> SAC Yes No v SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: ����� <br /> Fire Deparcment: (��(,At(,� Post Office: (�..t,U�-1c.c� _— School District: p/LtaNNt7 <br /> Lot Area: Sq.ft. /�t� G�ANGL Acres — Width — Depth ^ <br /> Survey Submitted: Yes � No Date of Survey: orv t=�u3 U9•�1•�( <br /> Proposed Setbacks: <br /> Front (Lake): �J`5�I �' Right Side: ! 3(�� �' <br /> � <br /> Rear (Street): �(,�� t- Left Side: ,3S 1 <br /> Adjacent Structures: �TI14GbIz� Wetland: N�� <br /> Building Height: Def. Hgt. (y .�- Peak Hgt. "� <br /> Lot Coverage: N (14 <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Se tic: Staff A roval Date: '��''" O BY� �✓ <br /> P PP <br /> Zoning File: # Resolution: # Resolution Date: <br /> A Shoreland District: <br /> N.1 Avg. Setback: Bluff Setback: L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />