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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 2 cez S N 0 2-rrf ��o� pd2i vc <br /> PID: ' <br /> DESCRIPTION OF WORK: �v�•�o p� <br /> ZONING REVIEW BY: DATE APPROVED:�-9-o Y <br /> B UILDING REVIEW BY: DATE APPROVED: �(- 7 - o Y <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLANREVIEW Yes J No SEWER CONNECT70N <br /> STATE SURCHARGE Yes_�" No WATER COIVNEC770N <br /> INVESTIGATION FEE Yes No ,/" PARK FEE <br /> SAC Yes No � SITE INSPECT70N <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: �D C �..y�.�.�� <br /> 4` <br /> Fire Department: Post O,�ce: School District: <br /> LotArea: Sq.ft. Acres Wcdth Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wet[and: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> Lot Coverage: <br /> Grading: Sta,�`'Approval Date: By: Council Approval Date: <br /> Septic: Sta}�`'Approval Date: By: <br /> Zoning File: # Resolution:# Resoluaon Date: <br /> Shoreland District: <br /> Avg.Setback: Bluff Setback: � Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> asasoo� <br /> 500-1000' . <br /> Hardcover Variance Required: Yes No Date of Council Approval: � <br /> REMARKS(in house): y <br /> 32 <br />