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CHECK OFF LIST FOR ISSU.q.NCE OF PERMITS <br /> FOR OFFICF USE ONL�" <br /> ADDRESS OR LEG_AL: (�"�� ( �g�l� ��5��� ��,f <br /> PID: <br /> DESCRIPTIOIVOFGi'ORK: A��Y„� �'ZE <br /> ZONINGREi�IE��B�:• �� ~^ Y DATEAPPROI'ED: � L pfi����U� <br /> B UILDING RE['IE N'B�:• DATEAPPRO i�ED: 5-z�-pc, <br /> FEES TO BE CK4RGED: Misc. Fees Calculated B��: � ~_��_� � <br /> PERMIT �'es ✓ No y <br /> � PLA11�'REVIEN� Yes �/ No SEYT�ER CONNECTION <br /> STA7'E SURCH.4RGE I es r/ No N'ATER CONNECI'ION <br /> INT'ESTIG_�ITIDIV FEE �es No � PARK FEE <br /> S�1 C �"es No ,/ SITE Ih'SPECTION <br /> Number of SAC Unit� �$�2o g3 y,-t 1 -b°t OTHER (spec�) <br /> � -- ---.;�=�.L¢.�"�`-�--_______________________ �___________ <br /> ZONING CHECIi LIST ZoningDistrict: �--R— ( � � � � �~ ��� <br /> Fir�e Department: Post Ofjice: School DistricT: <br /> P(us �cr'nzh c,�tS <br /> Lot Area: Sq.ft. Acres a, �G'idth ��d � Depth Z20 � <br /> Su��vey Submi�ted. 3 es� No Date of Su�vey: S 2 7 O� ('2�� S-/Z(o��p <br /> /'2,�/ � <br /> Rroposed Setbaclu: �O/�/�U� <br /> �tlLake): g8/ Ri�it Side: �� .� <br /> �o�d 2� _ ' "� �� .�' b����� �S 6g��,��L <br /> � <br /> �(Streel�: �p� �t Side: . <br /> 3? a-- � <br /> � � ,9djacent Structxrres: /�,G�- N"etfand: ��' -' � <br /> / <br /> Building Height: Def Hgt. �� Peak Hgt. �8 � Z gj <br /> Lot Coverage: ��� �� ^ <br /> /?Qvl$2G{��//d( <br /> Grading- SeaffApproval Date: S1Z-��OS Bl' d ,sp,� C-acrrreri'Appraval Date: �Z/ Q r(o�1���/ofq <br /> Septic: StaffApproval Date: � Bl(�� S� b��g� <br /> Zo�7ing File: � (�j-337� Re,rolution: # Resolution Date: /� ?� <br /> Shorelaivd District: A1CND Pe�- <br /> Avg. Setback: p K BIz�Setback: ot overage; <br /> �r�.,�-�, �,.�� � <br /> Hardcover: 0-,�5' <br /> �S ��0 -�� Z,S % <br /> �.i0-�00' <br /> son-�oon� <br /> Hardcover f�'aria�ace Reqzrired: I�es� 1�o Date of Cozmcil tlpproval � �� <br /> REIILARKS(ii1 hnuse): <br /> �3 <br />