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Plan Review Checklist for Zoning Permit Applications <br /> Address: I � w� <br /> Description of work: ` <br /> Type of permit: <br /> Zoning review by: Date Approved: "t • �'�1-- <br /> Grading review by: � Date Approved: �'Q•(L °�-�(y�� Q <br /> Other Review, Reviewed by: Date Approved: <br /> Zonin : <br /> Zoning File#: ���2� Resolution#: ! _�,^ Resolution Date: <br /> �� t..�� V/ <br /> Lot Area: SF/AC Width: Depth: <br /> Survey Submitted? 0 Yes o D te of Survey <br /> dar�anc� (� <br /> �•Z-l 2_ <br /> Existin Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Proposed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> ShOreland DiStriCt MCWD Permit ReCeived Average Lakeshore Setback Met? � Bluff <br /> 0 Yes � No � N/A 0 Yes No <br /> Yes 0 No � Yes 0 No � N/A <br /> Permit Number: Setback: <br /> Hardcover Zones Existin Proposed Variance Required C P Re uired <br /> 0-75' ���I rn_ �r^•�� m0 Yes ❑ No es 0 No <br /> �,�A �� .,� <br /> 75-250' �5� (XJ TYPe(S)� �,.4.� Type�s�� (�•1�j� . <br /> �-- <br /> 250-500' Zoning File#:I ��JIYa Zoning File#:'L,�� <br /> L- <br /> 500-1000' Resolution#: �(� Resolution#: �� r^ <br /> lY <br /> Created: March 29,2011 <br /> z:\forms\plan review checklist for zoning permit applications.docx <br />