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. . <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> � ADDRESS OR LEGAL: �5 Z 2 L�v i�.�v s�N <br /> PID: <br /> DESCRIPTION OF WORK: dJ�c rr�c.�-��..'� .,�F 2h 6� <br /> ---------- --------- -------------------__--_-----------------------:---------_____ <br /> ZONING REV�W BY: �_ DATE APPROVED• y-S-o 0 <br /> BUII.,DING REVIEW BY: DATE APPROVED: K- �=nd <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes �/' No <br /> PLAN REVIEW Yes f No SEWER CONNF.CTION <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 /> ZONING CHE.CK LIST Zoning District: GR-/L <br /> Fire Department: Nl u vn�� Post Office: (�J R VZ,�+�1r4 School District: t�E S�N Ic/a <br /> Lot Area: Sq.ft. �3�'?�o o Acres � 3 Width I b o� Depth �3 Z-' <br /> Survey Submitted: Yes_� No Date of Survey: Z -ZT- 4 I <br /> Proposed Setbacks: <br /> Front(L-e�e}: y 3� Right Side: 1� ' <br /> Rear(Sueet): (�F� Left Side: (�'�' <br /> Adjacent Structures: 2 S' Wetland: N(y�4 _ <br /> Building Height: Def. Hgt. c9•IL Peak Hgt. '� <br /> Lot Coverage: �n.3`7� <br /> Grading: Staff Approval Date: N �� By: — Council Approval Date: " <br /> Septic: Staff Approval Date: /J(r4 — By: -- <br /> Zoning File: # N(�'�' Resolution: # Resolution Date: <br /> Shoreland District: I�rU <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />