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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: S`1 S ����=5� 1gM�n s t,�rv L <br /> PID: <br /> DESCRIPTION OF WORK: ��G.�� �- �o�t�-e�. <br /> -------------------------------------- ------- - ---------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: S•3i� �� <br /> BUILDING REVIEW BY: DATE APPROVED: s• 3r �v� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓� No <br /> PLAN REVIEW Yes f No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓l No WATER CONNECTION <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,,Q•/Q <br /> Fire Department: ��n��p Post Office: yvLo�,v,/> School District: �,u2 s Ton►t�1 <br /> Lot Area: Sq.ft. N� C/�,.�Acres --- Width — Depth — <br /> Survey Submitted: Yes p< No Date of Survey: g'l3'9 Z �0� t���� <br /> Proposed Setbacks: � � <br /> F��(Lake): �qU � Right Side: 7S <br /> Rear (Street): �5� �- Left Side: CI� � <br /> Adjacent Structures: pn,�a�H-�.T►'� Wetland: n/ //� <br /> Building Height: Def. Hgt. N/�" Peak Hgt. — <br /> Lot Coverage: C���C. <br /> Grading: Staff Approval Date: — By: — Council Approval Date: — <br /> Septic: Staff Approval Date: — By: — <br /> Zoning File: # -- Resolution: # — Resolution Date: — <br /> Shoreland District: <br /> Avg. Setback. N//'-I Bluff Setback: — Lot Coverage: — <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' (�•(L <br /> 500-1000' <br /> Hardcover Variance Required: Yes No DL Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />