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�• ,r,. <br /> ' CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �5 S � �..Y iZ � C. � v�:. <br /> PID: <br /> DESCRIPTION OF WORK: ��,(�,,q;�L �=r� ��;it�;A c�� <br /> ---------------------------------------------- ---------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: ivJ Lff,rr-..� <br /> � <br /> BUILDING REVIEW BY: DATE APPROVED: y-�3—ol <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ,� No <br /> PLAN REVIEW Yes • No ✓ SEWER CONNECTION <br /> STATE SURCHARGE Yes _1� No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: /V v C /-�� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres W dth Depth <br /> Survey Submitted: Yes No ate of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wetlan : <br /> Building Height: Def. Hgt. Peal:H t. <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 Setback: j L.ot Coverage: <br /> Existing i Proposed <br /> Hardcover: 0-75' <br /> 75-250' � <br /> 250-500' <br /> 500-1000' � <br /> � <br /> Hardcover Variance Required: Yes No�_ Date of Council Approval: <br /> REMARKS (in house): rliv �'i r-�� �,�,�-, � /�—c��'?i�� <br /> 7 <br />