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. * <br /> . � <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> • � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Z 2 65 d c v�� �,Ar�� <br /> PID: <br /> DESCRIPTION OF WORK: G +� �'-� 6 c �-,o r� �-n �n� <br /> -------------------------------------- --------- ------------------------------------------------------i----��-- <br /> ZONING REVIEW BY: � DATE APPROVED: 3 � <br /> BUILDING REVIEW BY: DATE APPROVED: 3- z Y-c�� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes c/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: IZ�Z- 1(� <br /> Fire Department: �.c�.v� (/4(Ge: Post Office: (.e�.�,�>u-" School District: (��Z�.'�v <br /> Lot Area: Sq.ft. /vo L t-h�.�Acres Width Depth <br /> Survey Submitted: Yes � No Date of Survey: �!'Z`�� f4`7 �n, F��� <br /> Proposed Setbacks: <br /> Front (Lake): S�� Right Side: Zb0 � � <br /> Rear(Street): /s� � Left Side: �Z � �' <br /> Adjacent Structures: j�-�--r-r-�c.t-+ e c� Wedand: ,'✓(�� <br /> Building Height: Def. Hgt. D-<< Peak Hgt. — <br /> Lot Coverage: 0� � <br /> Grading: Staff Approval Date: C��(L By: o�'�. Council Approval Date: <br /> Septic: Staff Approval Date: �l� By: <br /> Zoning File: # � Resolution: # � Resolution Date: <br /> Shoreland District: N� <br /> 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 />