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. , <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: cl to c� �r.e5 i w=�,�"�./v Y�/�-�� <br /> PID: <br /> ` DESCRIPTION OF WORK: ��I���r�; tw:�crt,�-�- ����-n.�...» A-�,vs l�C= .Sr�2� <br /> -----------------------------------------------------=------------------------------------------------------------------ <br /> ' ZONING REVIEW BY: � DATE APPROVED: G Z3 5� <br /> BUILDING REVIEW BY: DATE APPROVED: <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes a/ No <br /> PLAN REVIEW Yes No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATER CONNECT`ION <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: /c/� c c� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wetland: " <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: #f Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: I.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Da[e of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />