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. CHECR OFF ZIST FOR ISSIIANCE OF PERMITS <br /> � . . FOR OFFICE USE ONLY <br /> -> -- �,.... .. _ <br /> . .. _ <br /> �__. �.�; _ ,. __.._. <br /> _ - -: :..___ ._ PID. `� �-- ;_._�:._.__. ...:�..__._--�-=---�--- - <br /> ADDRES S OR LEGAL. Z�Z'l'�� 1�2��► ' ._. <br /> DESCRIPTION OF WORR: //4iDO1 77�/`� - . _ _ . _ <br /> -------------------- - - --- ---------------- --- <br /> . . . ` _ : <br /> _ ...: _ - - ---.. . .__ __ -. ._ <br /> ZONING REVIEW BY: DATE `APPROVED. . �e "� Z X"'S_ - <br /> . - - _ : . ;_ ..... <br /> .. . . _ _ ,,DATE APPROVED: • (�_" ��. 1'"� `/ - <br /> BIIII,DING REVIEW BY: � <br /> FESS TO BE CHARGF,D: Misc. Fees Calculated By: <br /> . ✓ <br /> PLANIREVIEW __ Yes�No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � P�K FEE ` <br /> SAC Yes No_� SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECR LIST -----------------Zoning District---G 2 ���------------------ <br /> Fire Department:��J/(,o ��..c� Post Office: (.c�•4^�?i9-r�a- School District: � ��� <br /> Lot Area: Z + /a-GIZ-C S Width: ��2.rLe-G v��✓,�- Depth: `-" <br /> Survey Submitted: Yes � No Date of Survey: 3--I �-( -�i� <br /> Proposed Setbacks: � <br /> �ron�t (Lake) : l !:� } Right Side: <br /> R�ar (Street) : zs-r�� 3" Lef t Side: 3J � ` <br /> Adjacent Structures : �'�t�f� Wetland: /��/�' <br /> Bui�ding Height: Def. Hgt. �.(L- _ Peak Hgt. <br /> Avg. Setback: �d�-�-��W�- �92�� Lot Coverage: iV �% <br /> Existing Proposed <br /> Hardcover: 0-75 ' �• Z`� `��� �(� . <br /> 75-250 ' 2J�.�f4`�o Z�• �Z-�=- <br /> aso—soo � 3• ��`f1� � �— <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes No� Date of Council Approval: <br /> Grading: Staff Approval Date: y Council Approva�. Date: <br /> Septic: Staff Approval Date: B � <br /> Resolution # : 3 i � 3 Resol.ution Date: � � z7�y y <br /> Zoning File:# (5 3 � . <br /> REMARKS (in house) : <br />