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- • � , � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> , FOR OFFICE USE ONLY <br /> ADDKESS OR LEGAL: l ��� E=-►a��2 N e55 (�o�N� J Z�� <br /> PID: <br /> DESCRIPTION OF WORK: 1<.rc.�{�r•r �Za�o c>�� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: � DATE APPROVED: Z-r K-02 <br /> BUILDING REVIEW BY: DATE APPROVED: Z- r�t -oz <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓' No <br /> PLAN REVIEW Yes .�— No SEWER CONNECTION <br /> STATE SURCHARGE Yes .� No WATER CONNECTION <br /> INVESTIGATION FEE Yes I*To �� PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST zoning District: No Gtf'/aNCaCr <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetl . <br /> Building Height: Def. Hgt. Peak gt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: y: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setbac : 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 /> REMARKS (in house): <br /> 7 <br />