Laserfiche WebLink
CHECK OFF LIST FOR fSSUA1VCE OF PER�ti,tITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3`l3S L�v �N�sZ-o�v Av e. <br /> PID: <br /> DESCRIPTION OF yl�O.RK: 1^/1 o u� ��' ���6� <br /> ------------------------------------- -------- -------------------------------------------------------- <br /> ZOtYI[VG REVIEyV BY: ,_ DATEAPP�OVED: / z -i-o Y <br /> BUILDING REY,fEW BY: DATEAPPROVED: i z- �-o X <br /> -------------------------------- <br /> FEES TO BE CHARGED: Nlisc. Fees Calccclated By: <br /> PERI�IIT Yes =� No <br /> PLANREVIEyV Yes r/ �Vo SEYVER GO�VtVECTION <br /> ST�lTE SURCHARGE Yes � !Yo tiVATER CO�Wt ECTIOIV <br /> I��TVESTIGATION FEE Yes �Vo �/ PARK FEE <br /> Sf:tC Yes No �/ SITEINSPECTIOtV <br /> Nu�nber of SAC Units OTHER (specify) <br /> ----------------------------------------------------------------------------------------------------------- <br /> ZONI[YG CHECh'Ll'ST Zorting Dlsb•ict: CJQ-��- <br /> Fire Departrreerrt: Post O�ce: Scl:ool Dfstr•ict: _.. <br /> Lot.�trea: Sq.f't. C�,"1�1'1 flcres . �� YYidtf: SO � Depth <br /> Survey Subrriitted: Yes X No Date of Sitivey: �oT 30• o`( <br /> Proposed Setbacks: <br /> F�•ortt(b�e): `{�•� Riglit Side: 2-� <br /> Rear(St�eE+i): 51 Geft Side: 1� <br /> Adjc�cent Structures: '2�7' Wetland: N I A <br /> Berilding Height: Def. Hgt. U•k Peak Kgt. — <br /> Got Coverage: f q�fl <br /> Grading: Staff.�pprovnl Date: — By: CotuTci!Approvc�!Dc�te: <br /> Septic: Staff.�lpproval Date: — BY� <br /> Zonir:gFile: # 0�1-305� Resolution: # Resoli�tionDnte: I,-ZZ' o`I <br /> Shoreland Dish•ict: �p-e� _ <br /> Avg.Setbnck: N�— Blceff 5etback: — Lot Cover•age: <br /> Existing Proposed <br /> Ha�•dcover: 0-7.i' <br /> 75-250' <br /> 250-500' <br /> 500-1000' 3S ; . <br /> Hardcover Variance Required: Yes No �� Date of Co�c�scil Approval: <br /> RE1I�IARKS(in hottse): <br /> 31 <br />