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, � CHECR OFF LIST FOR ISSDANCE OF PERMITS <br /> ' FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �'�'l(� /V u la f2►�'� �.�rZ PID:� �;- j� � ' -->_ ', �', � c C � �. <br /> DESCRI PTION OF WORR: /U EL-� le C=. S <br /> ------------------------------------------------------------------------------- <br /> ZONING REVIEW BY: �,,,���v.c•.� DATE APPROVED: �s"'C1" % 3 <br /> BIIII�DING REVIEW BY: ���ti•�._- DATE APPROVED: �"`� - 4 �3 <br /> -------------------� ------------------------------------------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes� No SEWER CONNECTION <br /> STATE SURCHARGE Yes�� No WATER CONNECTION <br /> INVESTIGATION FEE Yes � No �' PARK FEE <br /> SAC Yes No � SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ---------------------------------------------------------------------------- <br /> ZONING CHECR LIST Zoning District: (,�- l� <br /> Fire Department: ✓1�.:w� Post Office: �.>,�� School District: �,��Src+v��l <br /> Lot Area: i ?�o, �'��s� t r Width: /�j S Depth: G o0 � "�' <br /> Z,'�-7 /}c/t-Gt7 <br /> Survey Submitted: Yes �C No Date of Survey: �- 2�r- y � <br /> Proposed Setbacks: , � � <br /> Fz'6nt- (Lake) : /.5�1 '+- Right Side: d• `I � <br /> B..�a-� (Street) : Z�� �- Lef t Side: i�. Z- <br /> Adjacent Structures: 2� � Wetland: �V�/-�- <br /> BuiJ.ding Height: Def . Hgt. Peak Hgt. <br /> Avg. Setback: (�.(L Lot Coverage: �. (<- <br /> Existing Proposed <br /> Hardcover: 0-75 ' V <br /> 75-250 ' �t• � <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes No pc Date of Council ApprovaJ�: <br /> Grading: Staff Approval Date: � ��-� By: Council Approval Date: <br /> Septic: Staff Approval Date: 7�15-S3 BY= �� W <br /> Zoning File: # eso�ut' on # : ResoJ.ution Date: <br /> RF.MARRS (in house) : <br />