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CHECK OFF LIST FOR ISSUAi�TCE OF PER1l�IITS � � <br /> ' . FOR OFFICE USE Oi�1L.Y <br /> ADDRESS OR LEGAL: Z�t�c.� ,p v ntw c��v�y Y�v�= <br /> PID: <br /> DESCRIPrrITION OF WORK: �b��-R ��--5 <br /> , _____ <br /> ZOY�'G REY�`� BY: D�TE APPROV�D: rc� -3 -c�� <br /> BUII.DPtG REV�ti� BY: DATE APPROVID: �o - 3 -n� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �� No . <br /> pLAN REVIEW Yes ✓� No SEWF.R CONIVEC'TION <br /> STATE SURCHARGE Yes � No WATERCONNEG"TION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SI'TEINSPEC"TION <br /> Number of SAC�Units OTHER (specify) <br /> ZOr`L�G CH�CK LIST zoning District: G 2-i C_ <br /> Fire Deparcment: �v�� Post Office: �a�-�-�� School Discrict:�}�b1-t�N 1�-�- <br /> Lot Area: Sq.ft. I j 3`61 Acres � .35 Width ��3.�� Depth I �� � <br /> Survey Submitted: Yes p�. No Date of Survey: �-�2--�� <br /> Proposed Setbacks: <br /> Front (Lake): 3 c�' Ri�ht Side: � S <br /> Rear (Screet): 3� � Left Side: < <(� <br /> Adjacent Structures: r4-�-t-�+.u-�«9 Wetland: N 1/i . <br /> Buildin� Height: Def. H�t. D.l� Pea.�Hjt. O.I�. <br /> Lot Covera�e: , t� <br /> Gradin�: Scaff Approval Date: C�• Ic. By: � U� Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zonin�File: # �-- Resolution: � — Resolution Date: <br /> Shoreland District: y�p 7 <br /> AvQ. Setback:� r� [� LotCoverage: !'��° <br /> � M� ,/J. Blufi Setback: <br /> EzistmQ Proposed <br /> � <br /> Hardcover: 0-7�' <br /> 75-250' (�"�`' � <br /> 2�0-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REI�IARKS (in house): <br /> 7 <br />