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' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I�3 I 5 F A��2 N E SS P o,N i-- CZ-c�A O <br /> PID: <br /> DESCRIPTION OF WORK: Po2cl-i <br /> -----------------------------------------------------------------------------------------------�----_-----�----- <br /> ZONING REVIEW BY: � DATE APPROVED• 1 z3- S <br /> BUILDING REVIEW BY: DATE APPROVED: �- 2.3� q 8 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes �— No SEWER CONNECTION <br /> STATE SUR:�-IARGE Yes � No WATERCONNECITON <br /> INVESTIGAT'ION FEE Yes No PARK FEE <br /> SAC Y;;s No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ----------------------------------------------------------------------------------------------------------------------- <br /> ZONING CHECK LIST zoning District: L2-I L. <br /> Fire Department: YY►o�rv�p Post Office: �,,��qxZA71�- School District: p20n1 O <br /> Lot Area: Sq.ft. 2'�,l0 30 t Acres •(,3 Width �RIlE.6U�A2 Depth <br /> Survey Submitted: Yes X No Date of Survey: ON r'Itk Z'�b•`a� <br /> Proposed Setbacks: � <br /> Front (Lake): _ `?2� + Right Side: LI`-( '� <br /> � +, r � <br /> Rear(Street): �{0 Left Side: (OS <br /> Adjacent Structures: la-r�c�t-�`"'� Wetland: �-(O� } <br /> Building Height: Def. Hgt. C��k Peak Hgt. U• �� <br /> Lot Coverage: D.k <br /> Grading: Staff Approval Date: �I (/� By: � Council Approval Date: — <br /> Septic: Staff Approval Date: N (�4 By: <br /> Zoning FIle; # N �V�- Resolution: # — Resolution Date: — <br /> Shoreland Dis�ict: <br /> Avg. Setback:�l'4 Bluff Setback: (�I �f4 Lot Coverage: C�• k <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' I o /� <br /> 500-1000' <br /> Hardcover Variance Required: Yes No � Date of Council Approval: <br /> REMARKS (in house): _ <br /> • 26 <br />