Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERII�IITS <br /> _ FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3 b� c.� L�4�nc�s't�r� ,4�r c:. . <br /> PID: <br /> DESCRIPTION OF WORK: �LC.I�.S <br /> . - <br /> ZO�'G RE'VIE`V BY: � DATE APPROVED: g- 2�(- � <br /> BUII.DP�tG REY��BY: DATE APPROVED; � -2� =vo <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes ✓ No ; <br /> PLAN REVIEW Yes � No SEwIIt CONNECTTON <br /> STATE SURCHARGE Yes�� No WATER CONNEG"ITON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZO�G CH�CB LIST Zoning District: � <br /> � ' Fire Department: Post Office: School District: � � <br /> fi��` <br /> t Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes�_ No Date of Survey: Or�S t i l,t: <br /> Proposed Setbacks: F� R�3�n2 Fna�►r R�-."gR . <br /> Front(Lake): 2 " s'�`� Right Side: � �' � �' <br /> Rear(Street): l l �} Ry� '�= Left Side: � � 'k ?-0 � <br /> Adjacent Structures: A�r�U,.4-��fl Wetland: N I� . <br /> Building Height: Def. Hot. /�I /✓� Peal:Hgt. <br /> t Covera�e: <br /> Gradi.no: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> N � • Zoning File: # Resolution: !# Resolution Date: <br /> Shoreland District: <br /> Ava. Setback: Bluff Setback: I.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> Zsasoo� <br /> soo-i000� <br /> Hardcover Variance Required: Yes No Dace of Council Approval: _ <br /> RE�iA.RKS(in house): <br /> 7 <br />