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� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: S�{c� /�r n2.�* (-1�2�,,. +(�/C <br /> PID: <br /> DESCRIPTION OF WORK: �,�I <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: � DATE APPROVED: (�-2-S°l <br /> BUILDII��G REVIEW BY: DATE APPROVED: 6_Z-g q <br /> / <br /> FEES TO BE CHARGED: 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 PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAG Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: � 2-�►�} <br /> Fire Department: y��.,},,../1 Post Office: vv�,�" ,•,.� School District: Wey-n,,.�'Ic�. <br /> Lot Area: Sq.ft. nw c_1-t�Ayuc,cAcres �-- Width — Depth — <br /> Survey Submitted: Yes OC. No Date of Survey: oi., �� � <br /> Proposed Setbacks: � ��,�� <br /> Fl�t(Lake): I Za-�" �� Right Side: I �(j� , <br /> �� r <br /> H�ar (Street): ?�� Left Side: ! 5 <br /> Adjacent Structures: I 3` Wetland: N( ✓} <br /> Building Height: Def. Hgt. N(� Peak Hgt. ���f{- <br /> Lot Coverage: it1�� <br /> Grading: Staff Approval Date: — By: - Council Approval Date: <br /> Septic: Staff Approval Date: — By: <br /> Zoning File: # 2 S� 3 Resolution: # r`/'Sj(v i Resolution Date: S-� �� <br /> Shoreland District: <br /> Avg. Setback: U F��v�,c� Bluff Setback: �v o L.ot Coverage: N (.�► <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No p� Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />