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� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> ` FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: S"vU 11Jdti�'� i9,�� <br /> PID: <br /> DESCRIPTION OF WORK: l,��N�O c.,� <br /> --- --- __--____-------------------------------------------------------------------- <br /> ZONING REVIEW BY: ��- DATE APPROVED• <br /> BUII.,DING REVIEW BY: DATE APPROVED: � �.V—� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes �� No � SEWER CONNECITON <br /> STATE SURCHARGE Yes �/ No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: N� Cr��p <br /> �` <br /> Fire Department: Post O�ce: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Reaz(Street): Left Side: <br /> Adjacent Swctures: Wetlan : <br /> Building Height: Def. Hgt. Peak H t. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: ` <br /> Zoning File: # Resolution: # esolution 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 />