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, • <br /> CHECK OFF LIST FOR ISSUAIYCE OF PE.R1ti.fITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3�o �N ��"`'P <br /> PID: <br /> DESCRIPTIO:V OF 6vORK: '��"�� <br /> ---------------------------------------- <br /> ---------------------------------------------------- <br /> ZOtVI�VGREUIEY[�BY: DATEAPPROVED:/� ��� <br /> B UILDItYG.REVIEW B Y: DATEAPPROVED: �v'�+�•vy <br /> ----------------------------------- - <br /> FEES TO BE CHARGED: tL�Iisc. Fees Cc�lccciczted By: <br /> PER11�fIT Yes ✓ No <br /> PLANREVIEGV Yes tVo � SEYVER GOtViYECTION <br /> STATE SURCH.4RGE Yes_�� �vo yVATER COtWi ECTIO�V <br /> INVESTIGATIOtV FEE Yes No PARK FEE <br /> SAC Yes No SITE tNSPECTIO�V <br /> Nctrnber of SAC Units OTHER (specify) <br /> ------------------------------------- <br /> ZO�YI[VG CHECh'LIST Zor�ing Disd•ict: � �' <br /> Fire Deparhreerrt: Post Office: Schoo!District: __. <br /> Lot.�trea: Sq;�1. �lcres 6Yidth Depth <br /> Scuvey Subr�iitted: Yes No DRte of Sccrvey: <br /> Pr•oposec!Setbacks: <br /> F,•ait(Lalce): Rigl:t Side: <br /> Rear(Street): Left Sicfe: <br /> Adjacent Struct�u•es: Y�etland: <br /> Bccildirig Height: Def. Hgt. Peak K t. <br /> Lot Coverage: � <br /> G�'ctding.� Staff Approvccf Date: B, : Council Approval Date: <br /> Septic: Staff.�lpproval Date: <br /> Zoning File: # Resolutiai: # Resolution Date: <br /> Shoreland Dish•ict: <br /> Avg.Setback: Bluff Set ck: Lot Cove:•age: <br /> Existing P�•oposed <br /> Ha�•dcover: 0-7.i' <br /> 75-250' <br /> 250-500' <br /> 500-!000' _� <br /> Kardcover Variance Required: Yes No r�. Date of Council Approval: <br /> RE111ARKS(ire hotcse): <br /> 31 <br />