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���o �; ���� _ <br /> � , • CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRBSS OR LEGAL: ���� ,�/�I� C��.�e /(� ���• PID: Da - ��7- � 3 �� `� �CJU�'�`J <br /> DESCRIPTION OF WORK: ���'c.Pis� ���'12G��� <br /> ----------------------�-!�-------------------------------------- <br /> ------------ <br /> ZONING REVIEW BY: /V DATE APPROVED: <br /> BIIILDING REVIEW BY: DATE APPROVED: �'' �f" �1 � <br /> FEES TO BE CHARG$D: � Misc. Fees Calculated By: <br /> PERMIT Yes / No <br /> PLAN REVIEW Yes � /No SEWER CONNECTION <br /> STATE SURCHARGE Yes �� No WATER CONNECTION <br /> INVESTIGATION FEE Yes No�� PARK FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------ <br /> ZONING CHECR LIST Zoning Distric : <br /> Fire Department: Post Office: School District: <br /> Lot Area: 'dth: epth: <br /> Survey Submitted: Yes o Date f Surv <br /> Proposed Setbacks: <br />� Front (Lake) : Ri t Side: <br /> Rear (Street) : L ft Side/ <br /> Adjacent Struct res : � Wetl d: <br /> , <br /> , <br /> Building Height: D f. Hg P ak Hgt. <br /> Avg. Setback: � L t Cov rage: <br /> Exist ng Prop sed <br /> ! <br /> i-T�r�Cp��or: �-75 % <br /> 75-2 0 ' <br /> 250- 00 ' ' <br /> �`� � <br /> 500 �1000 ' �' <br /> Hardcover Variance Regui . Y No D of Council Approval: <br /> Grading• Staff Approval D te: By: Council Approval Date: <br /> Septic. Staff Approval Date: By: <br /> Zoning File:# Res lution #: Resolution Date: <br /> REMARRS (in house) : <br />