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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> ' FOR OFFICE U�ONL <br /> ADDRESS OR LEGAL: _ �� �"� J—��. � �e �:� <br /> PID: <br /> DESCRIPTIDNOF WORK.• q/�,�,.�o� <br /> ZONING REVIEW BY.• DATEAPPROVED:_ 7/Z �/C}�� <br /> B UILDING REVIEW BY.• DATEAPPROTfED: -�- Z 3 _� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: ` <br /> PERMIT Yes � No <br /> P���E� Y�S—�r No SEWER CONNECTION <br /> STATE SURCHARGE Yes—�� No WATER CONIVECTION <br /> WVESTIGATION FEE Yes No �/' PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> IJumber of SAC Units OTHER (spec�) <br /> ZONING CHECg LIST Zoning District.• �� ' ! � � <br /> Fire Department: Post Office: School District: <br /> � �/ <br /> Lot Area: Sq.ft. • Acres �• � � Width � f0`� � Depth - C�7 1 <br /> / �-> t v�c f c�Cl�2 S We-1-/�x+�t 0�/ <br /> Survey Submitted: Yes �/ No Date of Survey: j y � �1 <br /> Proposed Setbacks: � ��p. � <br /> Front{� �O�� �ht Side: %?C� C{'�,�r�� <br /> s��1�� l � . <br /> Rear(�rec�E): /I o C�qr ci 4- -�.e,�Side: �/O C�!�y�Q . _. <br /> e �- c:c-'IC� G� i-o' E <br /> A d j a c e n t S truc tures: 6 1 6� Wetland: l�d � P � � <br /> � �S /�, +'►��z 3 <br /> Building Height: Def.Hgt. Peak Hgt. ���'I�22-t t+� <br /> Lot Coverage: �{� <br /> Grading.• StaffApproval Date: /�/�I By: Council Approval Date: <br /> � ��Septic: StaffApproval Date: �" �- (,��By; <br /> Zoning Fi1e; # Resolution: # Resolution Date: <br /> Shoreland District: �� MCWD Permit: <br /> Avg. Setback: BZuffSetback: — LotCoverage: --� <br /> Existing Proposed <br /> Hardcover: �- <br /> -�3-�3�'' <br /> 2.i D-S00' �— �--- <br /> 500-1000' � �4 7 . �(�•��`�c�� 1 e 7 ��7 O Z rd� <br /> Hardcover Yariance Required: Yes No �/ Date of Council.Approval.� <br /> REMARKS(in house): �/'G C /-����;v� �(�f`- � Q/� <br /> /� P,S' �''(� C�, y' <br /> _ �l'/�/�'7CI _�' CYC.�c> Z G2C�' ,�Vr .� h� � � v�� c,;��iut� <br /> 33 <br />