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! ' <br /> CHECK OFF LIST FOR ISSUANCE OF PERIVIITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ^�1SS l—tiJ N�" ��4�.A Q'tfl!�� <br /> PID: <br /> DESCRIPTIO�ti OF 6VORK: Go•�NDAr�1o� i'?.� � <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: I A _ DATEAPPROVED: <br /> BUILDING REVIEW BY: _ DATEAPPROVED: '�•�30-o'� <br /> FEES TO BE CHARGED: / Nlisc. Fees Calcz�lated By: <br /> PERMIT Yes �/ No <br /> PLAN REVIEW Yes /No� SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATER COIWECTION <br /> INVESTIGATION FEE Yes No_�� PARK FEE <br /> SAC Yes No t/� SITE INSPECTION <br /> Nz��yabe��of SAC Unils OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST 7_o��ii�g Disrr icr: /vo C I-/ti9s�1ro C <br /> Fire Departnrent: Post Office: School Dish•ict: <br /> Lot Arecr: Sq ft. .4cres GY'idth Depth <br /> Scrrvey Subrnitted: 3'es No Date of Scrrvey: <br /> Proposed Setbacks: <br /> Frazt(Lalce): Rigl�t Srde: <br /> Rear(Sh•eet): Lefl Side: <br /> Adjacent Strarctures: Gf� dand: <br /> Buildi��g Heigl�t: Def. Hgt. P ak Hgt. <br /> Lot Coverc�ge: <br /> Gr•nding: StcrffAppy'oval Date: t�: Cozrncil,�lpp�•oti�al Date: <br /> Septic: Stnff.4pproval Dnte: 1� � <br /> Zoning File: �? Resolution: # Resolution Date: <br /> Shoreland District: �blCGG'D Per•iyrit: <br /> ,�1 vg. Setback: B/irff Setback. Lot Cove��age: <br /> Ezrsting i Proposed <br /> Hnrdcover: 0-'�' } <br /> 7�-??0' � � <br /> zso-son� <br /> son-�000� � <br /> Ha��dcover ['nria��ce Reqirired: }'�s ��'o� D�ite of Caiu�cil.�l pp��oi�nl: <br /> RE�YI,4RKS(iji lrouse): <br /> 33 <br />