Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> � ADDRESS OR LEGAL: I�{0 Gvc.r�vv�/r L c,v �2 <br /> PID: <br /> DESCRIPTION OF WORK: C3A s C n��T r—r r�s r� <br /> —_-- - -- _ _--_____---------------------- <br /> --------------------------- - <br /> ZOr`Pi 1G REVIEW BY: � DATE APPROVED: c{• }v-0 2 <br /> BUILDING REVIEW BY: DATE APPROVED: �..�. �o--a2 <br /> , <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes �/' No <br /> PLAi�1 REVIEW Yes �' No SEWER CONNECITON <br /> STATE SURCHARGE Yes ✓ No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZO�TIl�'G CH�CK LIST Zoning District: a <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres idth Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wetlan : <br /> Building Height: Def. Hgt. Peal:H t. <br /> L,ot Coverage: <br /> Grading: Staff Approval Date: By: � Council Approval Date: <br /> Septic: Staff Approval Date: By: I� <br /> �- <br /> Zoning File: # Resolution: # �esolution Date: <br /> � <br /> Shoreland District: I <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing I 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 /> � <br /> 7 <br />