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� <br /> � <br /> CHECK OFF LIST FOR ISSUA:rCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �L1�5 LON C� LAKE 3LV� <br /> PID: <br /> DESCRIPTION OF WORK: I�EGK 2EPA�R <br /> _--_-- ______---------- --------_---_---------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: y�1,� -ao <br /> BUII.DING REVIEW BY: DATE APPROVED: y-/r-v o <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes No � SEWER CONNECTION <br /> STATE SURCHARGE Yes � No WATERCONNEC"TION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: /U 0 G H�4NG+e <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: We and: <br /> Building Height: Def. Hgt. Pe Hgt. <br /> Lot Coverage: G <br /> � <br /> Grading: Staff Approva�'Date: �y: Council Approval Date: <br /> � <br /> Septic: Staff Approval Date: �y: <br /> Zoning File: # Resolution: !t_� Resolution Date: <br /> Shoreland District: I' <br /> i <br /> Avg. Setback: Bluff Setbac : Lot Coverage: <br /> Existing ; Proposed <br /> Hazdcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />