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. � , . <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3y 5� �-y�`�- +4v-2 <br /> PID: <br /> DESCRIPTION OF WORK: (�;�.t.�,p�� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: itI �/a DATE APPROVED: <br /> BUILDING REVIEW BY•� DATE APPROVED: � • �I - g 5 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes '� No <br /> PLAN REVIEW Yes (�� No t� SEWER CONNEC'I'ION <br /> STATE SURCHARGE Yes ✓ No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONII�TG CHECK LIST Zoning District: Nv G H�- <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 Sid : <br /> Rear (Street): Left Side <br /> Adjacent Structures: etland: <br /> Building Height: Def. Hgt. eak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: #� Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setb ck: L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> �00-1000' <br /> Hardcover Variance Required: Yes o Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />