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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ��� 3 S Sv� ����c_.r�_ <br /> PID: � <br /> DESCRIPTION OF WORK: A�s `` /-1 Y Cc-�S �� a �� }� <br /> ZONING REVIEW BY.• � � DATEAPPROVED: �l <br /> BUILDING REVIEW BY.• DATEAPPROVED: <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 SITEINSPECTION <br /> Number of SAC Units OTHER (spec�) <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Off ce: School District: <br /> Lot,4rea: 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 /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: StafJ`'Approval Date: _ By: Counci!Approval Date: <br /> Septic: Staff Approval Date: By.• � <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: MCYi�D Permit: <br /> Avg. Setback: Blu,f,�'Setback: LotCoverage: <br /> � Existing Proposed <br /> Hardcover: 0-7.i' <br /> 7.i-250' <br /> 2.i0-.500' <br /> 500-1000' <br /> Hardcover G'ariance Reguired: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> i <br /> , 33 <br /> 4� <br />