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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3�z5 �=-o>c ST'_ <br /> PID: <br /> DESCRIPTION OF WORK /��O i���5 �-- 0�.� (�q/i�4 6 C: <br /> ------------------------------------ ------ ------------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATEAPPROVED: i z�z i -c�� <br /> BUILDING REVIEW BY: DATEAPPROVED: � Z-z�-�y <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calciclated By: <br /> PERMIT Yes ✓� No <br /> PLAN RE VIE W Yes �/ No SE WER CONNECTION <br /> STATE SURCHARGE Yes ./ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No� PARK FEE <br /> SAC Yes No �/ SITE INSPECTION <br /> Number of SAC Uyaits OTHER (speci_fj�) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zo��ing Distr�ict: <br /> Fire Dep�u•tnient: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Su�vev Submitted: Yes�_ No Date of Siavey: <br /> Proposed Setbacls: <br /> Front(Lake): —1�1y Right Side: ��� <br /> Rear(Sti•eet): j(�� Left Side: I I l�•�d <br /> Adjacent Structures: 0•1� Wetland: N I►4 <br /> Building Height: Def. Hgt. p,k Pea1t Hgt. — <br /> Lot Coverage: � (u� <br /> Grading: StaffApproval Date: ��_ 2i _�•�� By: � Council Appr-ovul Date: <br /> Septic: StaffApprovuJ Dute: /�/iA- By: — <br /> Zonin�File: # Resolution: # Resolc�tion Date: <br /> Shoi•e(and District: u�5 <br /> Avg. SetbacTc: � •�L Bluff Setback: �✓I,� Lot Coverage: — <br /> Existing Pi•oposed <br /> Hardcover: 0-75' '� o <br /> 75-250' 0 O <br /> 250-500' G .s9 ��•3� <br /> 500-1000' <br /> Hardcover Var•iance Required: Yes No 'x Date of Co�nzcil Approval: <br /> REMARKS(in hoarse): <br /> 33 <br />