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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFIC� USE ONL Y <br /> ADDRESS OR LEGAL: 34gd /t/u�,s'�� <br /> PID: <br /> DESCRIPTION OF WORK Ad 9�+''�1G c,�i�I DrirC'h � //vl/I4 -���}ee.._A'�—� <br /> ----�gl�'-'�vb--f-�-`'-'�°�=�---�rnu r_ �-- �='='--- -�-- --�------ --------- <br /> ZONING REVIEW BY.• DATEAPPROVED: �I— I3 ' �� <br /> BUILDING REVIEW BY.• DATEAPPROTjED: f i-�Y-�b <br /> FEES TO BE CHARGED: Misc. Fees Calcz�latecl 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 r/ SITEINSPECTION <br /> Nzm�ber of SAC Units OTHER (spec�) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning Drstrict: L� _l�j <br /> Fire Departi�7ent: Post Office: School Distf•ict: <br /> LotAr�ea: Sq.ft. �5�� �`f� Acres G�idth ��� Depth ��--� � <br /> Su�•vey Sa�bnzitted. Yes� No Date of Sa+rvey: ���ZC(�; y��is �Ll <br /> �t��,�'� � <br /> Proposed Setbacks: <br /> Fvont(Lake): �'I� C`IAr+q 2� Right Side: /70 C'lV-}yrqQ� <br /> Reai•(Street): .�S� l Left Side: i'�O c;+'I�m,9�2 <br /> Adjacent Structures: �_ GVetland: I <br /> ' s�iz5 i�'C��,,:nwni l <br /> Bcrrldrng Height: Def. Hgt. Peak flgt. ,,� Z h� .�-ty �t��.etv,�h Z, <br /> c� -�x��� ��,yh <br /> Lot Covef•age: �. � � <br /> Grading: Sta�fApprova/Date: I�� Gl+� Bv: � Council,4pproval Date: <br /> Septic: StaffApproval Date: �l/� By: <br /> 7oning File: # Resolirtion: # Resoh�rtia�Date: <br /> Shoreland District: '1 :tlCYi'D Permit: <br /> Avg. Setback: 0•K 6/1 ff Setbncic: �✓�� /ot Coverage: S.6'`�a <br /> Existi��g Proposed <br /> Har•dcover: 0-7�' Z I Z�'%�' ��{72-- <br /> ?.i-_'.i 0' _� � '->>/ ,�i z�-►7 <br /> 250-�00' -t I q(r� � �I 9� <br /> 500-1000' <br /> Hardcover [%ariance Reyaured: }es �Vo r,:� Date ofCotrneil.<lpprova/: <br /> REMARKS(inhou.se): � �' Cc��.,' � S� {' �S—ZScS ,�� c� 7S-Z50 <br /> i S I es S 5`% , ,� ,\ c,v� ' i v , . <br /> � !J rYICX'� rM U� NL I VI T��L 7S ' ZS� ��M�- <br /> 1�Iv►��h�slv�h�� A�pr�„�� c:F ���'-j �lclrhvh— ��rc.vvtrci ol- r1���� I�K�`,hca�� <br /> ��Ca�� ��- �S S5� �v�d �dr ,= �n� ��,:. iS lacAlQc1 to hu� m�r�ntie.. c:r� <br /> I/��¢.���2wr o� hws�s ov� e��,�, s�d ic. . <br />