Laserfiche WebLink
CHECK OFF LIST FOR ISSUAi�TCE OF PERI�IITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: !S�� FO k 5 T <br /> PID: <br /> DESCRIPTION OF WORK: GA�,2AG c_ A 4D� n�� <br /> ZO�'G RE'V�W BY: DATE APPROVED: ? -Z y -o fl <br /> BUILDING REVIEtiV BY: DATE APPROVED: �- �t -�� <br /> FEES TO BE CHA.RGED: Misc. Fees Calculated By: <br /> PERNIIT Yes ✓ No . <br /> PLAN REVIEW Yes v No SEWER CONNECTtON <br /> STATE SURCHARGE Yes ✓ No WATER CONNEC'I ION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZO�r'G CHE.CK LIST Zoning Disuicc: N lL <br /> Fire Department: Post Office: School District: <br /> Lo[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 /> . � <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peal:Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> � Septic: Staff Approval Date: By: <br /> �' <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: Nv <br /> Avg. Setback: Bluff Setback: I.ot Coven'e: <br /> Eusting 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 />