Laserfiche WebLink
CHECK OFF LIST FOR TSSUANCE OF PER�I�IITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: <-1 6 5 H vn1 r�R ,o/�ss � <br /> PID: <br /> � DFSCRIl'TION OF WORK: �ao�. <br /> ------------------------------------ <br /> ZONING REVIE`V BY: C�i�,,,,�,,_ DATE APPROVED; ----_�y----- <br /> BUILDING REVIEW BY: � DATE APPROVED: <br /> ------------------------------- ----- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PEFtMIT Yes �/ No ' <br /> PLAN REVIEW Yes �/ No SEWER CO�TNECTION <br /> STATE SUR`H1�RG� Yes � No WATER CONNECTTON <br /> IivVESTIGAT'ION-PEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ----------------------------------- ----- <br /> ZO�TING CHECK LIST Zoning District: JZR- �� <br /> Fire Department: (,.c>o„ �ic.c„ Post Office: �,r,a�,�,y�- School District; C�tz_oN0 <br /> Lot Area: Sq.fr. n�o Gff�°�+"GC Acres — `yldth � -DePth —.– <br /> Survey Submitted: Yes � No Date of Survey: p,� �=�t,C� <br /> Proposed Setbacks: <br /> Front (L�cc): . ( S�� Right Side: �3U ' + <br /> Rear(�rcet): 7�00 ` + Lefr Side: �S' �' <br /> Adjacent Structures: 3O` tiVetland: /V//�' <br /> Building Height: Def. Hgt. N I /� Peak Hgt. — <br /> rLot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> � Septic: Staff Approval Date: By; <br /> � <br /> Zoning File: # Resolution: # Resolution Date: <br /> v,I� Shoreland Dis�ict: <br /> r Avg. Setback: Bluff Setback: Lot Coverage: <br /> � Ezisting Proposed <br /> Hardcover: 0-75' <br /> 75-250' . <br /> 250-500' . <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes No Date of Council Approval: <br /> RE1I�ARKS (in house): <br /> • 26 <br />