Laserfiche WebLink
' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ( �� G c���p`�v �i� � �2 <br /> PID: <br /> DESCRIPTION OF WORK: (,��C� <br /> Z0��1G REVIEW BY: DATE APPROVED: y-�g -oz <br /> BLJILDING REV�`V BY: DATE APPROVED: Y -��-o--L <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 WATER CONNEC'ITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZONI�'G CH�CK LIST Zoning District: �Z.2 • 13 <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depch <br /> Survey Submitted: Yes_� No Date of Survey: dn� �=i cti <br /> Proposed Setbacks: � <br /> Front(�ej: Z���{ Right Side: '3 Z �' <br /> Rear (S�eef}: 11� ± Left Side: ! 2S'± <br /> Adjacent Structures: _�q-r-iwc i-f-�'� Wetland: nl //� <br /> Building Height: Def. Hgt. D .t�- Peal:Hgt. <br /> Lot Coverage: — <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'J <br /> Av�. Setback: Bluff Setback: L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1Q00' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />