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. j ' CHECK OFF LIST FOR ISSUAI�ICE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRFSS OR LEGAL: l l�v G o�b u�►v� �w <br /> PID: <br /> DESCRIPTION OF WORK: P,�q,�e w�.�.-r�T- �=�n,�s�t <br /> ZOr'I�'G REV�W BY: N I A DATE APPROVED: <br /> BUII�DLIIG REVIE`V BY: DATE APPROVED; i z-1 g a3 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PER►1�IIT Yes ✓ No <br /> PLAl�T REVIE`'V Yes �' No SEWER CO�INEC"ITON <br /> STATE SURCHARGE Yes � No WATERCONNECITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZOrT"G CH�CK LIST Zoning District: �v o C Ft�nlc, �r . <br /> ✓ <br /> Fire Dep�,-tment: Post Office: School Districr. <br /> Lot Area: Sq.fr. Acres Width Depth <br /> Survey Submitted: Yes • No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Righ[ Side: <br /> Rear (Street): Left Side: <br /> Adjacen[Structures: �Ve land: <br /> Buildin;Hei;ht: Def. Hgt. Pe �Hgt. <br /> Lot Co�•::a�e: <br /> Gradin�: Staff Approval Date: B : Council Approval Date: <br /> Septic: Staff Approval Date: B ; <br /> Zonin� FLe: � Resolution: � Resolution Date: <br /> Shorela�d Discrict: <br /> Avg. Setback: Bluff Setback: Lot Covera;e: <br /> Existin� Proposed <br /> Hardcover: 0-7�' <br /> 7�-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REl�L4RKS (in house): <br /> 7 <br />