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CFiECK OFF LIST FOR ISSUANCE OF PERIbIITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3 U�3 FA 2�((�W C..AQ�I�. <br /> PID: <br /> DESCRIP'TION OF WORK: CCK Z,L,PA 1� <br /> ---------------------------------_____----------- <br /> ZO'vING REVIEW BY: I� DATEAPPROVED: <br /> BUILDING REVIEW BY� DATE APPROVED: •5 <br /> 5'- `a 7 <br /> ------------------------ ------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes _� No <br /> PLAN REV�W Yes e� No c.� SEWER CONNEC'TTON <br /> STATE SUR�HAI�Gr Yes c� No WATER CONNECITON <br /> INVESTIGAZ'ION-FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> --------------------- ------- <br /> ZOI�TING CHECK LIST Zoning District: <br /> Fire Department: Post O�ce: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front rLake): Right Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: Wetland: <br /> �,` � ' Building Height: Def. Hgt. Peak Hgt. <br /> I"� " <br /> Lot Coverage: � <br /> Grading: Staff Approval Da[e: By: Council Approval Date: <br /> Septic: Staff Approval Date: By; <br /> Zoning File: # Resolution: # Resolution Date: � <br /> Shoreland DisLict: <br /> Avg. Setback: Bluff Setback: I.ot Coverage: <br /> � Ezis[ing 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 /> REiI�ARKS (in house): <br /> • 26 <br />