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r <br /> , CI3ECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRES5 OR LEGAL: Z��3 b nlo 5��, � 2 <br /> PID: <br /> DESCRIPTION OF WORK: �,o�,-e �,.,,q.c.c� <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING REVIEW BY: /t/(� DATE APPROVED: <br /> BUILDING REVIEW BY: DATE APPROVED: �� � 3-�6 <br /> ------------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes No ✓ SEWER CONNECTION <br /> STATE SUR:I�AAGE Yes �'' No WATERCONNECTION <br /> INVESTIGA'I'ION-FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: <br /> Fire Department: Post Office: Scl�ool istrict: <br /> � <br /> Lot Area: .ft. i res Width � Depth <br /> Survey Sub 'tted: Yes____� No Date of S�irvey: <br /> i , <br /> Proposed Se cks: � <br /> Fro t Lake): Right ide: 1 <br /> � <br /> Rea ( reet): Left S' e: <br /> I <br /> � <br /> Adj ent Structures: Wetland: <br /> Building Hei ht: ef. Hgt. Peak Hgt. <br /> Lot Coverag : <br /> . I %' . <br /> Gradmg: St ff Appr al Date. By: Council Approval ate. <br /> Septic: Staf Approval Date: By: <br /> Zoning File• # Resolution: # �Resolution Date: <br /> Shoreland ist:ict: � <br /> A . Setback: Bluf Setback: � L.ot Coverage: <br /> Exis ' g Proposed <br /> H rdcover: 75' <br /> 7 -25 ' <br /> 25 -5 ' <br /> 5 1 ' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> � 26 <br />