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' CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> . FOR OFFICE USE ONLY : <br /> - , . ��� ;. ___ ' _ _ <br /> . , _.. �. <br /> __ _ GZ�'j?�v'c�.` _: �.. PID. _ __�;:..._..:._ ._. ...._ ,:_.-: �_- - <br /> ADDR$SS OR LEG�I,: - �`� -�•�� �, �_ - - y, <br /> . :- _ : . , _ n � � l�-C9 � - _ <br /> , � - _ . . . ._ - � ,: , <br /> DESCRIPTION OF WORK: ►(�V <br /> ------- -------------------- ---------------- --- -- ---- <br /> --------------- - - <br /> - - - - ,_ <br /> . .: _.._. _. � .__--• DATE APPROVED: - -..�!`'"'a�f"G`f _._ <br /> ZONING REVIEW BY: � '��' <br /> BIIII�DING REVIEW BY: _ _ _ DATS APPROVED: ,s`/�-`T `( _ = . _ y: <br /> FEBS TO BE CHARGED: � Misc. Fees Ca�culated By• <br /> PERMIT Yes �No � SEWER CONNECTION <br /> PLAN REVIEW Yes No <br /> STATE SURCHARGE Yes C� 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: <br /> Fire Department: t Of ' ce Sc�4oJ. District: <br /> � <br /> Lot Area: Wi th: Depth: <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake) : Right Side: � L� �s���� �, <br /> Rear {Street) : Left Side: <br /> Adjacent Structures: Wetland: <br /> Buil.ding Height: Def. Hgt. Peak Hgt. <br /> Avg. Setback: 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 /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septi c: Staf f Approva7. Date: BY� <br /> Zoning File• # Resolution #: Resolution Date: <br /> REM�,RRS (in house) : <br /> ��.._.,�L:r.u.. i <br />