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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFI E USE ONLY <br /> ADDRESS OR LEGAL: ��3 I G,✓f GI �✓/�'I �YlL�� <br /> PID: � <br /> DESCRIPTION OF W�RK C ---------------------�H e��cl�K y s�M k� <br /> ---------�/•�_-���t o�Ic�- ��------------------------------------ <br /> ZONING REVIEW BY.• � DATEAPPRO[jED: Z �7 0 <br /> BUILDINGREVIEWBY: DATEAPPROi�ED: �z� 2� - o t, <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 /> ti� � INVESTIGA7'ION FEE Yes_� No PARK FEE <br /> ���' SAC Yes No SITEINSPECTION <br /> Nirmber of SAC Units � OTHER (spec�) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning Districl: C..I ' I <br /> Fire DeparUnerlt: Post Office: School Distyict: <br /> Lot Area: Sq.ft. Acres tiVicfth Depth <br /> Survev Sa�bniitted: Yes No Date of Sz�rvey: <br /> Proposed Setbacks: <br /> F�•ont(Lake): Right Side: <br /> Rear(Street): Left Side: C�p�l�(� <br /> h° <br /> Adjacent Strtictz�res: G6'etland: <br /> Building f/eight: Def Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Staf,J'Approva/Date: By: Council Approval Date: <br /> Septrc: StaffApp��oval Date: By: <br /> Zoning File: # Resolirtion: # ResoJirtion Date: <br /> Shor•ela��d Dis[ricl: NICGf'D Permit: <br /> r1tig. Setback: 6larff Setbac% Lot Coverage. __ <br /> Existing Pi•oposed <br /> f/ardcover: 0-�.5' <br /> �s-�sn� <br /> zso-�no� <br /> soo-roon� <br /> Hurdcover ��"aria��ce Reqa�ii•ed: }-es ��'o Date of Cocrncil flpproval: <br /> REMARKS(in house): CCe Sh'v�-n,v� u/ Gy! /i� l <br /> D f/ <br /> -fv e✓Y u <br /> -�- (�u 02!<. 5�92TZ.� (••f�d �cYt✓� , � <br /> 33 <br />