Laserfiche WebLink
� ' CHECK OFF LIST FOR ISSUAi�TCE OF PERi1�1ITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I y (o S �O x �St'SZ�c�—T <br /> PID: <br /> DESCRIPTION OF WORK: �4 pp � T7 o,vS <br /> ZO.�'G REVIE`V BY: DATE APPROVED: G • 26 -�� <br /> BUII�DING REVIEW BY: DATE APPROVED: (fl •Z� �a� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes ✓' No <br /> PLAN REVIEW Yes _� No SEWER CONNECTION <br /> STATE SURCHARGE Yes �,� No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZOVL1iG CH�CK LIST Zoning District: 1'C, `�, � 11� <br /> Fire Department: �A.ic,.� Post Office: Z_ School District: p!W n� <br /> L,ot Area: Sq.ft. t� G Acres Width Depth <br /> Survey Submitted: Yes�_ No Date of Survey: s"2-�_p� <br /> Proposed Setbacks: <br /> Front (Lake): �(ob `f Right Side: Z�l� -} <br /> g� , <br /> Rear (Street): �st Left Side: t <br /> c .}... <br /> Adjacent Structures: �/� Wetland: � <br /> Buildin� Height: Def. Hgt. C� . k- Pea�:Hgt. d, (�. <br /> Lot Covera;e: "" <br /> Grading: Staff Approval Date: —' By: Council Approval Date: <br /> Septic: Staff Approval Date: --- By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: M� 5 <br /> Avg. Setback: r/�� Bluff Setback: N �� L.ot Covera�e: N/�- <br /> Ezisting Proposed <br /> Hardcover: 0-75' <br /> 75-250' �•�� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No_� Date of Council Approval: <br /> REI�IARKS (in house): <br /> 7 <br />