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� , <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: Zt�"t5 F ox sz. <br /> PID: <br /> DESCRIPTION OF WORK: i2�,,,.t,o,�e� <br /> ---------------------------------------------- ------------------------------------------------------------------------ <br /> ZONING REVIEW BY: DATE APPROVED: �v� z�• o Z <br /> BUILDING REVIEW BY: DATE APPROVED: ,�. z� _ 0 2_ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �' No <br /> PLAN REVIEW Yes </ No SEWER CONNECTION <br /> STATE SURCHARGE Yes c�No WATERCONNECTION <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: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes p< No Date of Survey: �'��'92- <br /> Proposed Setbacks: <br /> Front (Lake): 2 I� Right Side: 8 0` + <br /> Rear (Street): �hp� Left Side: y�{p <br /> Adjacent Structures: pT-�7�G�f� Wetland: ^!(/� <br /> Building Height: Def. Hgt. o•�C.. Peak Hgt. — <br /> Lot Coverage: — <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: Bluff Setback: Lot Coverage: <br /> Existing 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 /> REMARKS (in house): <br /> 7 <br />