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. � CHE� OFF LIST FOR ISSIIANCE OF P$RriITS <br /> • FOR OF�IC� CSE ONLY <br /> / ' ��- -' _ � �'�- � <br /> ADDRSSS OR LEG�iL: � � `%'� _ �� rl �%"t �. �� �;���',� PID: l�� I I J - -�� � _'` - � � _' <br /> DESCRSPT20N OF WORR: �-`� �' f� 1 w �'L��'�Z� <br /> --------------------- - ----------------------------------- --- <br /> ZONING RLVIEW BY: DATE APPROVED: 6 ' 3 '�( <br /> BIIILDING REVIEW BY: c`�P�„�(v i�� DATE APPROVED: .S-.. ��' " �� , <br /> ------------------ <br /> FEES TO BE CHARG�: Misc. F�es Calculated By: <br /> PERMIT Yes �` No <br /> P�N REVIEW Yes �'� No SEWER CONNECTION <br /> STATE SIIRCHARGE Yes ;� ' No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � � PARK FEE <br /> SAC Yes No—� SITE INSPECTION <br /> Number of SAC IInits OTHER (specify) <br /> --------------------------------N��----------------- <br /> ZONING CHECR LIST Zoning District: <br /> Fire De�artment• o�l�_ Pos� Of�ice: � L- Sc:zool District: �� <br /> Lot Area: f(��� Width: Depth: <br /> Survey Submitted: Yes� No Date of Survev: � 'Z�-'�Zd <br /> Pr000seci Setbacks : r , � <br /> Front (Lake } ; .Q Riant Side: 2� <br /> Rear ( Stre�t) : /l1�/� Left Sice: �C� � <br /> Adjacent St�uctures : � Wet?and: ��/� <br /> Buildina Height: De�. Hgt. it/�/� Peak figt. /��/� <br /> Avg. Setbacx: (� •l� Lot Coverage: N/I`� <br /> Existing PL'ODOSed <br /> Hardcover: 0-75 ' <br /> 75-250 ' 2 ' , !� <br /> 250-500 ' <br /> 500-I000 ' <br /> Hardcover Variance Required: Yesp� No Date of Council Approval: <br /> Grading: Staff Approval Date: � p By: Council Apprvval Date: <br /> Septic: Staff Approval. Date: � BY� <br /> Zoning File:� Ibdy Resolution n: Resolution Date:_ <br /> Rffi�RKS (in house) :�. SoL�n o,v �2t�j 't-� � s� rel��� � <br />