Laserfiche WebLink
, � ' CHECK OFF LIST FOR ISSUANCE OF PERNIITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I 2 8� N a��� �R v� O R, � <br /> PID: <br /> DESCRIPTIOV OF WORK: SHE D <br /> ZO�TPi TG REVIEW BY: DATE APPROVED: I�•t 3-�3 <br /> BUII.DI�i TG REV�W BY: DATE APPROVED: �o-L 3-0 3 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes c/ No <br /> PLAN REV��V Yes_� No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WA'TERCONNECTION <br /> INVESTIGATION FEE � Yes No PARK FEE <br /> SAC Yes No SIT'EINSPECTTON <br /> Number of SAC�Units OTHER (specify) <br /> ZONING CH�CK LIST Zoning District: .. <br /> Fire Department: Post OfFice: School District: • <br /> Lot Area: Sq.ft. Acres � �idth Depth <br /> Survey Submitted: Yes No_� Date of Survey: -V s�-� Ex�P n o'�r <br /> Proposed Setbacks: , � <br /> Front(I.ake): / 3 7 Right Side: (O � <br /> Rear(Street): �/�'j � fi Left Side: !c� <br /> Adjaceat Structures: S�'� f Netland: -- <br /> Building Height: Def. Hgt. e .l� Peak H�. <br /> Lot Coverage: c�.Ic <br /> Grading: Staff Approval Date: _ iu i,�► By: Council Approval Date: <br /> Septic: Staff Appmval Date: — By: <br /> Zoning File: # — Resolution: # Resolution Date: <br /> Shoreland District: �.,�S <br /> Avg. Setback: tic v; Bluff Setback: � l� LotCoverage: N/✓� <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' 1► •GS /Z-"t-2 <br /> Hardcover Variance Required: Yes No� Date of Council Approval: <br /> REMARI�S ('ln house): <br /> 7 <br />