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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 1 %� ��x,��-,.z�(<z zti /�'��� /t,� <br /> �. <br /> PID: `T�_ ��� �l_�>��-��-_e., <br /> DESCRIPTION OF WORK: ;�,�. _ � ; i .. � j �,; ; � <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: �z• 30•�7 <br /> BUILDING REVIEW BY: DATE APPROVED: t Z•3�•4 7 <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 WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: (Z�-1(3 <br /> Fire Department: (�}�qyz.q�'T� Post Office: l�ur4y7�-7Y� School District: �}f}�"3,.A�'Ty� <br /> Lot Area: Sq.ft. Z..c�� Acres t37,S�v�f-. Width (7 S� Depth S00 <br /> Survey Submitted: Yes X No Date of Survey: I 1-2�v'S 7 <br /> Proposed Setbacks: <br /> Front (Lake): ( ?3•5 Right Side: 30.`I <br /> Rear (Street): "Z-��•� Left Side: S�.�- <br /> Adjacent Structures: /I/�f�' Wetland: N(A <br /> Building Height: Def. Hgt. 3d Peal:Hgt. 3� <br /> Lot Coverage: N/� <br /> Grading: Staff Approval Date: 1 2- 3 0 - 5 7 By: � Council Approval Date: — <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> N•'�� �s-Zso� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />