Laserfiche WebLink
�CIiECK OFF i.IST FOR YSSUANCE OF �'E�'KITS <br /> c AL: (�l���N�USE ONL'Y� � . <br /> ... r� A<a. 17���J� � <br /> A.DDRELS OR LEG <br /> PID: <br /> 'pESC�tIPTIO� OF WORK: �4-n�cH. �RA = <br /> �Q REVIE�4V SY: ^--- — --------------------- pATE APPFOYED: -�' ' . <br /> YN'G "^ <br /> D,p,,TE kJ?'PROYED� �- <br /> �UZLDLN'G REYIE�V BY: ,,•— . . <br /> '�EES TO BE C�TA�GEA' Misc. Fees Calculated By: <br /> PER��2IT Yes � N� — <br /> PLAN REVIEtiV � � Yes �/ No _ SE�YE.R CO�INEC'I70N <br /> / tiVATERCONNECTIO�T <br /> STATE SURCHARGE Yes v No _� �,�K FE,E <br /> INVESTIGATION FEE YeS —�' S�'EINSPECTION <br /> SAC Yes No � <br /> ' ' OTHER (specify) . <br /> --Number of SAC-Units------------------------------------------------------------------------------------ � <br /> ZON'Ii�iCY CH�CK LIST Zoaiag Districc; • <br /> ' Post Office: Schoot District: • <br /> Fire Dep3rtment: . <br /> Acres . �l � Widch � ?y� 7 te Depth t 9�1.? b <br /> Loc Area: Sq.ft.�`1r`�Z3 - <br /> Survey Submitted: Yes _� <br /> �o Date of Survey. "'� ' `►' °� <br /> �roposed Setbacks': , �� ,,' ' : <br /> Froat(Lake): 3s:"Z Ri�it Side: • . <br /> gear(Street): <br /> 1 S�7 Lefc Side: �`� <br /> Ad;a�eat Structures; r47'�'� <br /> Wetla�d; <br /> 0 <br /> Suil�in�Hei�t: DeE. Hgt, C�• k� Peak Hot. �— _ <br /> Lot Coveca�e: °____ <br /> rLo Councii A roval Date: ' <br /> GcadLng: Staff Approval Date: � • �'O7 By� �'�" pP <br /> Septic: Staff Approvai Dat:: � � �y� � <br /> Zooing File: �_= Resolutioo: R Resolution Date: <br /> ShorelandDistricc: ���5 r ,,g �,O;Cove2az: '�•`� <br /> Av;. Setbacb:: N + P Bl�fti SecSack: �✓ � <br /> ��5��o Proposed <br /> Hzccaver: �-��� —'— <br /> 75-250' — ----' <br /> 2�'J-���1;, ^ _1� <br /> y1j`�_�VV/�i ��ii I <br /> n�,� <br /> �/ �;` � ��.l.. V�'. \..�i'��i.. .1�I� r �1' <br /> �-?a-c�o•�:e- '�z`.�:ce Re�u�:re�: .e� � <br /> z.L�L�R�S �.L�h�'�e): <br />