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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: t(��.15 C.t n�oe N c.A r�tr - <br /> PID: <br /> DESCRII'TION OF WORK: (����-r-,,_ �,J //��b�L <br /> ZONING REVIEW BY: DATE APPROVED: y -��6 -o z <br /> BUII..DING REVIEW BY: DATE APPROVED: y_l� -o Z <br /> FEES TO BE CHARGED: Misc. Fees Calculated By:. <br /> PERMIT Yes �/' No � <br /> PLAN REVIEW Yes v� No SEWER CONNF,CITON <br /> STATE SURCHARGE Yes �� No WATER CONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTTON <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST zoning District: G'2-�l3 <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes_� �io Date of Survey: <br /> Proposed Setbacks: <br /> Frea�{Lake): �5� �' Right Side: 1 Y� �' N <br /> Rez�(Street): ��3 a� }' Left Side: W • 3 '—'s <br /> Adjacent Structures: /�! //� Wetland: /t! /.�4 <br /> Building Height: Def. Hgt. 2fS i Peak Hgt. 33� f <br /> Lot Coverage: a► � .� <br /> Grading: Staff Approval Date: ��Y.-o Z By: ,�J- Council Approval Date: ��-o z. <br /> Septic: Staff Approval Date: /� //�- By: <br /> Zoning File: # 0 2•2?S 7/�62� Resolution: !/ �bb Resolution Date: 3•z 5-�z <br /> Shoreland District: y.e� <br /> Avg. SetbacT o .,� Bluff Setback: -- LotCoverage: — <br /> Existing Proposed <br /> Hardcover: 0-75' �•Z, <br /> 75-250' y o.5 <br /> 250-500' 2 3�3 <br /> 500-1000' <br /> Hardcover Variance Required: Yes�_ No Date of Council Approval: 3` Z 5- 'z <br /> REMARKS(in house): <br /> 7 <br />