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� C�-IECK OFF LIST FOR ISSUANCE OF PER�I�LITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGA.L: ?"�-i�i �'1 � . v��c-c... �; �,- � <br /> PID: <br /> DESCRIPTION�F WORK: i�-�'%��� c..i�ti,����.� � <br /> �- c%�c�: . <br /> ------------------------------- <br /> ZO�tIiYG REVIEti� BY: /U i� DATE APPROVED: <br /> BUII�DING REVIEW BY: < �,�, �,,,�,;.� DATE APPROVED: 'j- i - �i.� <br /> -- --____--' -- --------------- ------------- -- <br /> FEES TO BE C�iARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓' No ' <br /> PLAN REVIEW Yes No c/� SEW�,R CONNECI'iON <br /> STATE SUR`H�,RG�. Yes �" No WATER CO'vNEC"ITON <br /> INVESTIGAZ'ION-FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: � <br /> /1,�u G if�t/t:' C�c�_ <br /> Fire Deparcment: Post O�ce: School District: <br /> L,ot Area: Sq.fc. Acres Width Depch <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (La.ke): . Right Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: `Vetland: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoni.ng File: # Resolution: # Resolution Date: � <br /> Shoreland DisL-ict: <br /> Avg. Setback: Bluff Setback: I.ot Coveraoe: <br /> � Ezisting Proposed <br /> Hardcover: 0-75' <br /> 75-250' � <br /> 250-500' � <br /> 500-1000' <br /> Hardcover Vaziance Requued: Yes No Date of Council Approval: <br /> i <br /> REI�ZARKS (in house): <br /> � . <br /> � 26 <br /> , ' � � <br />