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C�Ce OFF LIST FOR ISSIIANCE OF PSI2MITS <br /> ' rOR OF�IC� uS� ONiY <br /> ADDRES S OR LEG�I.: 3 I Z S f--'o X S T PID: O y- i�"1-Z 3 3 3 �O ( ! <br /> DESG�IPTION OF WORK: A�D I n o � - <br /> --- - ------------- ------------------------------- <br /> ------------- <br /> ----- --- <br /> ZONING R.EVIEW BY: DA� APPROVED: 3- �I - � <br /> BIIIZ�DING REVIEW BY: C�� DATE APPROVED: � � � - g 3 <br /> ---------------------- - <br /> FEES TO BE CHARG�• Misc. r^�es Calcula�ed By: <br /> pERMIT Yes �No <br /> PLr�N REVIEW Yes � No SEWER CONNECTION <br /> STATE SURCHARGE Yes�/No WATER CONNECT_TON <br /> INVESTIGATION FEE Yes No � PARK FEE <br /> SAC Yes No � SITE INSPECT=ON <br /> Number of SaC Units OTHER (speci�y) <br /> ----------------------- <br /> ZONING CHECK LIST ZoninQ District• L2-/� <br /> Fire De�artment: (,onr �c� Post Of�ice: �r c(s Sczool Dist,ict: pR,BN�O <br /> Lot Area: 3zs�s.z9 .yb �riatn: 3i�-1 •s i Depth: io��l � �' �-P <br /> Survey Submitted: Yes� No Date oi Surve��: Z��`� - S� <br /> Proposed Setbacks : � � <br /> Front (Lake i : 7 s� � �icnt Side : C 9 3� Z �" <br /> _vo` c� � -�- Ler� Sice: l,� ?�� ` '� <br /> Rear ( St_ ) : Z.lo <br /> Adjacent St�uctsres : N��/�' Wet�and: it/�l¢ <br /> i <br /> Building fieignt: De?=. figt. (7 � Peak Hgt. 2Z <br /> Avg. Setback: C7•/�- Lot Coverage : /✓ rt <br /> Existing Proposed <br /> Hardcover: 0-7� ` D <br /> i <br /> 75-250 ' � <br /> Z50-500 ' � <br /> 500-I000 ' �'7� �� <br /> Hardcover Variance Required: Yes No� Date of Council Approval: <br /> Grading: Staff Approval Date:_� BY= Council Apprvval Date: <br /> Septic: Staff Approval Date: -FS'�� BY� s � <br /> Zoning File•� Resolution �- Resolution Date:_ <br /> FLRMARiC$ (in house) : <br />