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' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 1 b c� fJ�c.�c�.y C.�4��, fJ 2�v-e <br /> PID: <br /> DESCRIPTION OF WORK: ,q p� i n �ti o�...c� �sx�s�-��G ��'n o N o` I��s� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: S- z�-S 9 <br /> BUILDING REVIEW BY: DATEAPPROVED: 5_ z� -�� <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 SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: r{iY� G(-�i41V(�� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: W tland: <br /> Building Height: Def. Hgt. Pe �Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: y: Council Approval Date: <br /> Septic: Staff Approval Date: y: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setbac : Lot 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 />