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�CHECg pFF LIST FOR ISSUANCE O�' �E��TS <br /> �'OR OFFICE USE ONLY <br /> -'�/1� v. z�.�; <br /> ADDRESS ORLEGAL: 1 �'l ' <br /> PID: aa� `��(O�►ti <br /> 77ESCRIF`z70N OF WORK: Iv� G�►z�d S.�i►�rL�oa� -� � — <br /> ------------- <br /> ----------- <br /> ---____�------ -----------___------------ pATE APPROVED: �Z`f Q <br /> ZO�'1�G REYIE�4V BY: 1���-- DA.T'E APPROVED; 6 - Y— o� <br /> �UILDING REYLEtiV SY: <br /> �`EES TO L'E C�-�G-Ep� Misc, Fezs Calculated By: <br /> P���T Yes ✓ No <br /> PLAN REVIEtiV � Yes � No SE�VFR COi�I�NECTION <br /> No tiVATER CONNECTION <br /> STATE SURCHAR.GE YeS � No � p�K FEE <br /> INVESTIGATION FEE YeS No —� STTEINSPECTTON <br /> SAC �'es <br /> OTHER (specify) <br /> Number of SAC�Units ------------------------------ <br /> --------------- <br /> -------------- <br /> --------------------------- <br /> ---1 i'� <br /> ZO! � G CT.-II�CK LIST zoaing Diatricc: �.� ' <br /> Post Office: Schaol District: � <br /> Fire Departs.ent: . <br /> Loc Area: Sq.ft. <br /> Acres A��= Widch � S 3 Depth 3`{ 6 <br /> Survey Submitted: Yes � <br /> �o Date of Survey: .� �` <br /> . y4,��K , <br /> Proposed Setbacks: �''� � e; � ,3 hAs�� <br /> Froat(Lake): �'� <br /> l3 ` �� <br /> Rear��)� 2 5 ' Ir�M3�ti Lefc Side: <br /> � <br /> F r>nt Ctn rit f , `�fPK�anrj; <br /> n��3.,.,�- 1- 1-2= �� �. <br /> JG h.� <br /> Suildin� Hei�t: DeF. Hgt, n� Pea_[c Ho . <br /> Lot Cevera�e: ►`1/k <br /> Grading: Scaff Approval Date: <br /> � 2 gy; ��_ Council Approval Dace: ' <br /> Szptic: S�af` Aporoval Date: `> ` �'U� �v: =�— <br /> Zo 'a�.ns Flle: ��_ <br /> Resolutioa. R R?solu:ior Da:e: <br /> Sho�zla�:d Disrric�: (�l�" r Lo:Coverage: <br /> �,v= Se�b2c:•_: Bluf�. 5etback: <br /> � P:oposed <br /> r,C!.StLe� . <br /> H�eco��P��, G-i�' — <br /> 7�-2�0' __. --" <br /> Z 5v-����,' ----" <br /> �_,..: <br /> _���-1G{��J <br /> �,„ - �,e.=__ .-._�- =. <br /> -�,-�,��;2C ����?r,___,,:� �'_tiU'.i2��'. :�2i . �_._ �. • - <br /> L;=1 t ���� (; i J�t�_�' <br />