Laserfiche WebLink
� CHECK OFF LIST FOR ISSUA.��TCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I��o Fcr�lp�Av� �`��� <br /> PID: <br /> DESCRIPTION OF WORK: EtiT/li4-s�� /vL���•�-�S t� r�r-i �•4%Z: <br /> Z0�1I�tG REVIE�V BY: DATE APPROVED: � •�b� o � <br /> BUII,DI�'G REVIEW BY: _ DAT'E APPROVED: � - i 6 - o s <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes �/ No SEWF�C0�INECTION <br /> STATE SURCHARGE Yes � No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No �/ PARK FEE <br /> SAC Yes No �/ SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> -----------------------------------____----------------------------------------------------------------------------- <br /> ZONI�IG CH�CK LIST Zoning Districc: <br /> Fire Department: Post Office: School Dis[rict: <br /> Lo[Area: Sc.ft. Acres Width Depth <br /> Survey Submitted: Yes_� No Date of Survey: o n< <=�v� I- Z S ' 0 5 <br /> Proposed Setbacks: , <br /> Front (Lake): Z� ' Right Side: �d i' <br /> Rear (Street): yoo� i Left Side: �"fJ� � <br /> Adjacent Structures: Z.y 0 � Wetland: '�J � 'ti <br /> Building Hei�ht: Def. Hgt. � 1 Peal:Hgt. <br /> Lo[Covera�e: � (l� <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: �"r By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: -� <br /> Av�. Setback: Bluff Setback: L.ot Coverage: <br /> Existin� Proposed <br /> Hardcover: 0-7�' <br /> 7�-250' <br /> 2�0-500' <br /> �00-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RE�iARKS (in house): <br />