Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 1 y21 rv,r�� �J/t . <br /> PID: <br /> DESCRIPTION OF WORK: F��.�. ' <br /> ZO.�iI�i 1G RE'VIEW BY: DATE APPROVED: 5'• Z� - ° 3 <br /> BUII..DING REVIEW BY: DATE APPROVID; <br /> FEES TO BE CHARGED: Misc. Fees CalcuIated By: <br /> .�'PERMIT Yes ✓ No <br /> PLAN REVIEW Yes No SEWER CONNECTION <br /> STATE SURCHARGE Yes No WATIItCONNECTiON <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 o GIfI�N� <br /> Fire Department: Post Office: School District: - <br /> Lot Area: Sq�.ft. Acres � Width Depth <br /> Survey Submitted: Yes No Date of Stirvey: <br /> Proposed Setbacks: � <br /> Front(Lake): `3� Right Side: .5 <br /> Rear(Street): � � f Left Side: .�t "' <br /> Adjacent Structures: �Vetland: <br /> Building Hei�ht: Def. Hgt. Peal:Hgt. <br /> Lot Covera�e: <br /> Gradin;: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # ResoluEion: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existino Proposed <br /> Hazdcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> � RE1�Z.A.RKS(inhouse): �(1��nr6 .A-e.���— /�o C � P < s�� �v��t u�f <br /> 7 <br />