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S�hor�lar�c� �istrict �!CC1dl�� Permi� �ver�ge Lakeshore Sett�acls ����' <br /> I�le�? <br /> � Yes � �o Permit I�umber: � Yes a No /A � Ye�o <br /> ��` C� N/a—see attached Setback: <br /> Sto�mwater Qualit�+ EXiS�QEE� Pro�oseci <br /> Qverfay District Tier H�rdco�e� hlarc�co�er Varia��� Reqt�irec9 CUP Required <br /> circle one % and s % and s <br /> � Yes t�o � Yes No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> i, Fees to 6�e Ghar ecf YES NO <br /> P�rmit <br /> E�{�n �e�€iev►r <br /> S�afi�sa�rchat^�e e/- <br /> Investigatio� Fee ✓'� <br /> SRC—Nur�bee of 5A� Ur�i�� (/` <br /> Other(s�ecif�) �� <br /> � uare F�a#a e $ �r S e��re Eoofia e <br /> Basement X = $ <br /> 1 S' Floor X = $ <br /> 2nd Floo� X = $ <br /> Garage X = $ <br /> Estimatec� Construction�al�e: �/ ��V �' <br /> Q�ar���rrspecti��s F�ec�uir°ecf F�'�rk(Req��rB¢�g Se�arate Per�6tg <br /> Footing E� Site � Plumbing � Grading/Filling <br /> � Poured Wall � Silt Fence/Erosion Control � iVlechanical � Fire <br /> � F�uroc�atior� Surv�� � Harcfcover Removal � Septic C� VVater Connection <br /> � Foundation Waterproofing Q Other(specify) � Fireplace � Sewer Connection <br /> Framing � lVlasonry O Lavvn Irrigation <br /> ❑ Insulation � Mfg. � Landscaping <br /> Q A�-Built�urvey� C� Other(specify) <br /> �Final <br /> � Lathe FFee��irec� S�ate Permit� <br /> � Other(specify) <br /> � �ell � Electrical <br /> ��filGe�RFtS (in-house): <br /> OFFICIA� P2EtVf�RbCS -TO BE t�OTED OI� PEI�fi61T AlN�3 INlTI�6LLE�. <br /> � �e� ��ilc�e . �,cknov�feclgerner�t�Qrrt� <br /> � Prior to releas of escrov�money an as-built survey and hardcover calculations must be submitted and approved. <br /> Updated: October 2015 <br /> �•\fnrmc\nlan roviaw rharklicf 1fl_9f11�,rinrtv <br />