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„ • . <br /> �C�IECK 4k'F i,TST FOR ISSUANCE ��' �E�1�IITS <br /> FOR OFFZCE USE ONLY• . <br /> A.DD�tE�S 4R LEGAL: n=,°-•'7 �� t( �`-I �v e <br /> PID: <br /> �DES CRIPI.�SO�T OF W ORK: �vl 'V,Av�CI� v1 r��^r”' <br /> ZOYl�tG REVIEtiV BY: ^--- ---- --------------DA'1'E APPROYED: lC��'�-/—r-0� <br /> - D,A,TE,A.PPROVED; • <br /> �UII�AING REVIE�Y BY: . . . <br /> � --- ------- — - -=-----------------------=-------------��-------------- <br /> FEES TO BE C�TARGED: Misc. Fees Calculated By: <br /> p��T Yes � No <br /> PLAN REVIEtiY '� Yes _� No SE�VER C�1�INECTION <br /> STATE SUR.CHAR.GE Yes �/ No `VAT'ERCONNECI'ION <br /> INVESTIGATION FEE Yes No _�� PARK FEE <br /> SAC Yes No � SITEINSPECTION . <br /> Number of SAC�Units OTHER (specify) . <br /> ZOyL.�tG CH�CK LIST� Zoaing District: � , <br /> Fire Department: Post Office: School District: • � <br /> Loc Area: Sq.ft. Acres � Width Depth <br /> Survey Submicted:� Yes No Date of Survey: <br /> �roposed Setbacks: � . : <br /> Froat(Lake): Ri�i.t Side: <br /> Rear(Street): Left Sid . <br /> A3;a�enr S!rucrures: Wetia�d• <br /> � <br /> Suildin� Heigh[: Def. Hgt. ! e d�- <br /> �,- � <br /> Lot Covera�e: ,�� <br /> �� • <br /> Gradin�: Staff App- D,�te: By: Council Approval Date: <br /> i <br /> Sepcic: Staff Appro��a!D2te: aY� �� <br /> Zoa�.ng File: � Resvlution: n Resolution Date: <br /> Shoreland District: <br /> Av;. Se[back:: B!uF�Setback: I.o:Cove2�e: <br /> E�sting Proposed <br /> H��ecover: G-7�' <br /> 7�-2�0' <br /> Z�0-5�.�:; <br /> �u�?-i CC�J' <br /> /' A �y..�l. <br /> ���CCO`r2' '��ZCi4^.C� Fi_GLii2�: .r2:i �;C iJ_._ i;i �.v�'�C:. n�•:. -• <br /> T�� <br /> t.E�L•�,�-�5 (.i.n h0�?5�,: <br />