Laserfiche WebLink
� CHECK OFF i�IST FOR ISSUANCE O�' PERIVIIT5 <br /> . FOR OFFICE USE ONLY <br /> ADARESS OR LEGAL: 2� �5 �x 5� <br /> PID: <br /> DESCRIP�!'ION OF WORK: _�g���,� s�� <br /> --- ------------ --------------------- <br /> ZOV�IG REVIEVV BY: DATE APPROVED: L/-Zy-O� <br /> BULLDI�i IG REVIE�V BY: DAT'E APPROVED: y- 2�/-o� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes f No <br /> PLAN REVIE`V � Yes ✓ No SE�zTER CO�INECTTON <br /> STATE SURCHARGE Yes � No `VATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------ <br /> ZONIti'G CHT,�CK LIST Zoning District: <br /> Fire Departm.enC Post Office: _ School District: <br /> Lot Area: Sq.ft. Acres Wid4h Depth <br /> Survey Submitted: Yes No�_ Date of Survey: iN�� ���0`� <br /> Proposed Setbacks: <br /> Fro� (Lake): �-(0 a� � Right Side: �I� � ± <br /> R�r (Street): 3� r Left Side: `�Sb �� <br /> Adjacen[Structures: 9�� � Wetland: �I �� <br /> i � � <br /> Building Hei�t: Def. Hgt. 5•S — Peal:Hgt. 1 I <br /> Lot Covera�e: N/� <br /> Grading: Staff Approval Date: � By: Council Approval Date: <br /> Septic: Staff Approval Date: � BY� <br /> Zonin� File: � — Resolucioa: # Resolution Date: <br /> Shoreland District: /�'v <br /> Avg. Secback: Bluff Setback: L.oc Cove�a�e: <br /> Etisting Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 2�0-500' <br /> S0a-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> RE:�L4RKS (in house): <br /> � <br />