Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 13 U G A�v iQCYZ CZx�v4/� <br /> PID: <br /> DESCRIPTION OF WORK: �J�;c..�t <br /> ZOr'ni 1G REVIEW BY: DATE APPROVED: l� • t Y •0 2, <br /> SUILDI�i 1G REVIE`V BY: DATE APPROVED: � •r 4 - o�. <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERII�IIT Yes ,/' No <br /> PLAi�t REVIEW Yes ,i-- No SEWER COiVNECTION <br /> STATE SURCHARGE Yes v�' No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No � STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CH�CK LIST Zoning Districr. <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes �C No Date of Survey: �1-ZZ-rd� <br /> Proposed Setbacks: <br /> Front (L�ce): �3S � � Right Side: 55� '}' <br /> Rear (St�eet): 1 SO� '�" Left Side: 1 bv� � <br /> Adjacent Structures: ����fn,/ Wetland: iv /A <br /> Building Height: Def. Hgt. — Peal:Hgt. — <br /> Lot Coverage: N (.� <br /> Grading: Staff Approval Date: — By: Council Approval Date: <br /> Septic: Staff Approval Date: ^ By: <br /> Zoning File: # �' Resolution: !� Resolution Date: <br /> Shoreland District: /V 0 <br /> Avg. Setback: Bluff Setback: L.ot Covenge: <br /> Existin; 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 />