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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> � ADDRESS OR LEGAL: �f S i'Vl ti2T�wodD �� <br /> PID: <br /> DESCRIPTION OF WORK: �-�� rT�a-G/fC,� <br /> -------------------------------------------------- -------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: /d- ,�'--5� <br /> BUILDING REVIEW BY: DATE APPROVED: �p • 5-7�g <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes (/ No <br /> PLAN REVIEW Yes V No SEWER CONNECTION <br /> STATE SURCHARGE Yes r/ No WATER CONNECTION <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: ��-1� <br /> Fire Department: ��/.�r�,,q.� Post Office: W�—y�-y-�- School District: lA1RU'ZA T►� <br /> Lot Area: Sq.ft. NO Gt��_Acres — Width — Depth " <br /> Survey Submitted: Yes_ < No Date of Survey: p�--5� 4$ <br /> Proposed Setbacks: � + <br /> Front (Lake): (,3 f Right Side: 33, <br /> Rear (Street): Z�� t Left Side: fU//4 <br /> Adjacent Structures: ATT7-►t/f� Wetland: li✓�� <br /> Building Height: Def. Hgt. (�� (�- Peal: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 Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />