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. � � <br /> CHECK OFF LIST FOR I5SUANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3►t-i S. J tq.�r+��—��-o�Pv� �� <br /> PID: <br /> DESCRIPTION OF WORK: o�1 <br /> ---------------------------------------- -------- ------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: 5'- 7 -u ( <br /> BUILDING REVIEW BY: N/� 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: 2�1.'/6 <br /> Fire Department: (,oK� L4-�[d Post Office: �"r�j��' School District: (�ltrst� <br /> Lot Area: Sq.ft. "�9,'-to� Acres I.rB Width �f2�?�6UV�(L Depth <br /> Survey Submitted: Yes_� No Date of Survey: �j 'ci �UO <br /> Proposed Setbacks: , � <br /> Frartt(Lake): I 23 Right Side: I 3Z � <br /> Rear (Street): Z S2� 't Left Side: 3�� <br /> Adjacent Structures: J� � Wetland: N �/-� <br /> Building Height: Def. Hgt. N �/� Peal:Hgt. � �� <br /> LotCoverage: ��.��-- <br /> Grading: Staff Approval Date: N �✓�" By: — Council Approval Date: <br /> Septic: Staff Approval Date: �-T, �� —�'1 By: �J' <br /> Zoning File: # ���..7 Resolution: # Resolution Date: I�--►5.- Ofl <br /> Shoreland District: y?� <br /> Avg. Setback: v�q,(t.�,�.rf�p Bluff Setback: ' �• � Lot Coverage: �•I� <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' 2S°^7-0 <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No p� Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />