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. •� . <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ('��S GR.�iv Zi?.�5 �,4� <br /> PID: <br /> DESCRIPTION OF WORK: (.�,�,�,�,vo(�.c,l_ <br /> ----------------------------------------- ------- -------------------------------------------------------------------- <br /> ZONING REVIEW BY: �— DATE APPROVED: ((�-�c�-�� <br /> BUILDING REVIEW BY: DATE APPROVED: ��-��(-S� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes c/ No <br /> PLAN REVIEW Yes �/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes !/ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No �____ PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONIl�'G CHECK LIST Zoning District: /�JU C{��91��E' <br /> Fire Department: Post Offi : School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Rig t Side: <br /> Rear (Street): Lef Side: <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peak 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: <br /> Avg. Setback: Q.�G- Bluff Setback: L.ot Coverage: <br /> Ex'sting Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes IVo Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />