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` � CHECK OFF LIST FOR ISSIIANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> A�DRBSS OR LEGAL: I S I D C��ZE E!Y 7 R�E,S pID= <br /> DESCRIPTION OF WORR: gE�R-OoM S�� "� <br /> ------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: /�/�/� DATE APPROVED: <br /> BIIILDING REVIEW BY: e7,,,�,co � DAT$ APPROVED: �/-/N`52- _ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ 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 ./ SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ---------------------------------------------------------------- <br /> ZONING CHECR LIST Zoning Dis ict: <br /> Fire Department: Post Office: Sc o� District: <br /> Lot Area: Width: Dept . <br /> Survey Submitted: es No Dat of rvey: <br /> , <br /> Proposed Setbacks � �� � <br /> Front (Lake) : R' ght ��de: <br /> j� �, <br /> Rear (Stre ) : eft �ide:� <br /> / <br /> Adjacent tructur s: Wettland: <br /> j � ; <br /> Building Heig t: Def . � gt. � �Peak Hgt., <br /> � � <br /> Avg. Setback ', Lot Cpverage: <br /> Ex' stin '/ Pr�posed <br /> �� � � ' <br /> ;' , �I <br /> Hardcover: 0-75 ' ; � <br /> i � � <br /> 7 -250 ' � i� <br /> , t <br /> 0-500 ' � J � <br /> � ,� <br /> 500-1000 ' � <br /> :� <br /> Hardcover Variance Required: � Yes No Date of Council Approva�: <br /> Grading: Staff Approva]. Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By= <br /> Zoning File:# Resolution # : Resolution Date: <br /> REMARRS (in house) : �, <br />