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. <br /> � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: i-�`► l��S lf�����(.v�ora �'��'�-r? � <br /> PID: � - < _��_, � � - ��_ <br /> DESCRIPTION OF WORK: �,r'/� C�i C`-v�' <br /> ----------------------------------------�----------------------------------------------------------------------------- <br /> ZONING REVIEW BY: � � " DATE APPROVED: �, - �w � '� <br /> BUILDING REVIEW BY: — DATE APPROVED: <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: �;�Misc. Fees Calculated By: <br /> PERMIT Yes�� No <br /> PLAN REVIEW Yes No SEWER CONNECTTON <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 /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Rear (Street): Left Side: <br /> �'� ' Adjacent Structures: Wetland: � <br /> '�� Peal:H t. <br /> � Buildmg Height: Def. Hgt. g <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: Bluff Setback: I..ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />