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_ * y CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> FOR OFFIC�E USE ONLY <br /> ADDRESS OR I�EGAL: 3'306 IU u4 V tA tZ 2L UA N�'�- pID= <br /> DESCRIPTION OF WORR: t.�-�-fL S <br /> --------------------�--�--,�----------------------- - <br /> ZONING REVIEW BY:__S�J�,� (SJJI�v�,e�._ DATS APPROVED: S - Z� � 4 S <br /> �' <br /> BIIILDING REVIEW BY: DAT$ APPROVED: � ' 2� -4 Y' <br /> ------------------- - <br /> F$ES TO BE CHARGF,D: Misc. Fees Calculated By: <br /> PERMIT Yes c/No <br /> PLAN REVIEW Yes �/' No SEWER CONNECTION <br /> STATE SURCHARGE Yes—� No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � PARR FEE <br /> SAC Yes No-v! SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------ • <br /> ZONING CHECR LIST Zoning District <br /> Fire Department: st O �School District: <br /> Lot Area: Depth: <br /> Survey Submitted: Yes�C No Date of Survey: �-Z 5-�� <br /> Proposed Setbacks: 9xiv g x'2 9x�� 8 x�'2- <br /> Front (Lake) : 't N Right Side: -Zc� '� � <br /> Rear (Street) : N/�9 $0��' Left Side: S''Z�� 60�- w <br /> Adjacent Structures: ���� Wetland: I'���- <br /> Building Height: Def. Hgt. Peak gt. <br /> Avg. Setback: Lot Covera e: <br /> Existing Propose <br /> Hardcover: 0-75 ' <br /> 75-250 <br /> 250-500 <br /> 500-100 ' <br /> Hardcover Vari nce Requi ed: Yes No Date of Co ncil Approval: <br /> Grading: Staff Approval. D te: B : Counci Approval Date: <br /> Septic: Staff pprova]. Dat : BY: <br /> Zoning File:# Re o tion Resolu ion Date: <br /> REMARRS (in h se) : <br /> I <br /> I <br />