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� <br /> � , � � CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> ' FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: _ 3t�Z o hr o(�.�� s��v�, p,2 <br /> PID: <br /> DESCRIPTION OF WORK: �Ky Cr� t� -t ►Zc Ezn o c= <br /> ---------------- <br /> ZONING REV�W BY: �� DATE APPROVED: <br /> BUILDING REVIEW BY: DATE APPROVED: y-!�-�i9 <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 /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST zoning District: �p c �,�`o <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Reaz(Street): Left Side: <br /> Adjacent Structures: We and: <br /> Building Height: Def. Hgt. Pe Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: Council Approval Date: <br /> Septic: Staff Approval Date: B : <br /> Zoning File: �/ Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Vaziance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />