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.. . <br /> . .�" , <br /> . CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: g,s"� /VO R77-/ /�lNr� �/Z <br /> PID: <br /> DESCRIPTION OF WORK: ���'S'S L���Oa�5 <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: /'�! �� DATE APPROVED: <br /> BUILDING REVIEW BY: DATE APPROVED: 3' -2.3-�c� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes t,� 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 SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: O <br /> Fire Department: Post Office: 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 /> Rear (Street): Left Side: <br /> Adjacent Structures: W land: <br /> Building Height: Def. Hgt. Pe � Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: B : Council Approval Date: <br /> Septic: Staff Approval Date: B : <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: L.ot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' � <br /> 250-500' �� <br /> 500-1000' � <br /> H <br /> r, <br /> Hardcover Vaziance Required: Yes No A Date of Council Approval: <br /> i <br /> REMARKS (in house): <br /> � <br /> � - <br /> 7 <br />