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�- CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADI7RESS OR LEGAL: Zyl O 47 u rJ w���H PID: <br /> DESCRIPTION OF WORR: L 1 C�►�i2'A��= - 2`'6"`�-'� A"F't'�R F�2� <br /> ------- ------------ <br /> ZONING REVIEW BY: � - DATE APPROVED: 10 - 12-9 5 <br /> BIIILDING REVIEW BY: � DAT$ APPROVED: (O- IZ-�rS <br /> -------- -------------- <br /> FEES TO BE CHARGED• Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes f No SEWER CONNECTION <br /> STATE SURCHARGE Yes �No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER ( specify) <br /> ------------------------------ <br /> ZONING CHECR LIST Zoning District: L 2-1L <br /> Fire Department• vn�d _ Post Office• (,�A�'i4'r►'} School District: v�eS'�'�NrtA <br /> Lot Area: ��,�y'� s� � Width: 1ZS Depth: /S 2--3`� /4�� <br /> Survey Submitted: Yes � <br /> No Date of Survey: ON �i�.E �1-�� '�� <br /> Proposed Setbacks: . <br /> Front (Lake) : "�'�� � fi Ri ght Side: r'- <br /> =� � � Left Side: ��' � <br /> Rear (Street) : - <br /> Adjacent Structures: (� � � Wetland: /�/�A <br /> Building Height: Def . Hgt. �.Is� Peak Hgt. — <br /> Avg. Setback: N Iq Lot Coverage: C�•I� <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 /> Grading: Staff Approval Date: 1�1 � By: Council Approva� Date: <br /> Septi c: Staf f Approval Date: l��V� BY= <br /> Zoning File:# — Resolution # : — Resol.ution Date: � <br /> REMARKS (in house) : . <br />