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� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 9?o (=o c'z..r.—sT �q,2v�5 �q�.Q <br /> PID: <br /> DESCRIPTION OF WORK: 3 5�.�a s��.r a'�-� � Y�ec_t� <br /> ------------------------------------------------,--�-J-------------------------------------------------------------------- <br /> ZONING REVIEW BY: L��--- DATE APPROVED: Y�V-� <br /> BUILDING REVIEW BY: DATE APPROVED: �l- Y- �� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SURCHARGE Yes J 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 Districr. L,2-/3 <br /> Fire Department: /Vw.,,,..✓� Post Office: yv���,�.�/� School District: �,.,.cs�,•+�r� <br /> LotArea: Sq.ft. �'7, `J4G Acres , `� Width �N�Z�✓+-2 Depth — <br /> Survey Submitted: Yes X No Date of Survey: 3 -f� -7 I <br /> Proposed Setbacks: <br /> Front (Lake): 3 5 Right Side: �i`i � 'F= <br /> Rear (Street): S'v� Left Side: S�'��T s�r� 35" <br /> Adjacent Structures: A-7'�bc t��''7 Wetland: N (✓'� <br /> Building Height: Def. Hgt. v,�� Peal: Hgt. �� k <br /> Lot Coverage: + Z"1� �' <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. Setbac : N//� Bluff Setback: �t/ //� LotCoverage: l Z`�d <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' f9 v � <br /> 500-1000' <br /> Hardcover Variance Required: Yes N� p< Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />