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� . . <br /> - r CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> . FOR OFFICE USE ONLY . <br /> ADDRESS ORLEGAL: Z 3d� �^��v�EW c��2cLr` <br /> PID: <br /> DESCRIPTION OF WORK: 1���-�,P,J (2.�=vwo�0�e L- <br /> ZO�TING REVIEW BY: N I � DATE APPROVED: <br /> BUII�DING REVIEW BY: DATE APPROVED: 3 .2� . �� <br /> __________ _______ --- -------___________________________ ---- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes � No <br /> pLAN REVIEW Yes No r/ SEOVER CONNECTION <br /> STATE SURCHARGE Yes ✓ No WAT'IIt CONNECTION <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: /vo c i-f�nrG� <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(Sueet): Left Side: <br /> Adjacent Structures: Wetl d: <br /> Building Hei�ht: Def. Hgt. Peal: gt. <br /> Lot Covera;e: <br /> Grading: Staff Approval Date: By Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: . . • . <br /> Shoreland Disuict: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hazdcover Vaziance Required: Yes No Date of Council Approval: <br /> RE�RI�S(in house): <br /> 7 <br />