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, � „ � CHECR OFF LIST FOR ISSIIANCE OF PF1tMITS <br /> FOR OFFICE USE ONLY <br /> ADDRSSS OR LEGAI.: 3 D�d �,l�,l��j :�,�9-f.P /�'/. PID: D�i�i 7 -a 3 3 �. �OC� 7 <br /> � � ��� Q . <br /> DSSCRIPTION OF WORR: /L-��ji/��%�� <br /> ---------------------- � <br /> ZONING REVIEW BY: /U��- DATE APPRO�. <br /> BIIILDING REVI$W BY: CX� DATS APPROVSD: `�-r� ~�Y <br /> ------------------ <br /> F$ES TO BE CEARGED: Misc. Fees Calculated By: <br /> PERMIT Yes f No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SURCHARGE YesJ� No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARR FEE <br /> SAC Yes No SITE INSPECTION <br /> Number of SAC IInits OTHER (specify) <br /> --------------------- <br /> ZONING CHEGK LIST Zoni g District: <br /> Fire Department: Post Office: Sc ol District: <br /> Lot Area: Width: Dept�i: <br /> i <br /> Survey Submitted: s No Date o Survey: <br /> Proposed Setbacks: <br /> Front (Lake) • Right Side: <br /> Rear (Street) : Left ide: <br /> Adjacent Str ture : Wetland: <br /> Building Height: ef. gt. -Peak Hgt <br /> Avg. Setback: Lot Coverage <br /> Exis ing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' <br /> 250-500 ' j <br /> 500-1000 ' I <br /> Hardcover Varian e Required: Yes No Date of Council Approval: <br /> Grading: Staff A proval Date: Hy: Council Approval. Date:_ <br /> Septic: Staff Approval Date: BY= <br /> Zoning Fi].e:# Resolution �: Resolution Date: <br /> REMARRS (in honse) : <br />