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, CHECB OFF LIST FOR ISSUANCE OF PERMITS <br /> . FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: 3�.� u n�o R-rw s�tiu- ,7�Z <br /> � PID: <br /> DESCRIPTION OF WORK: y.�,��� r� a.s {� I�w�o ,orv,a �-r�►4utt�J ���L46�e <br /> ZONIl�tG REVIEW BY: DATE APPROVED: �- 2� •o� <br /> BUII.DING REVIEW BY: DATE APPR4VED; � •2� •v�. <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: . <br /> PERNIIT Yes C�' No � <br /> PLAN REVIEW Yes c� No SEWER CONNECTION <br /> STATE SURCHARGE Yes c/ No WATER CONNECTTON <br /> INVESTIGATION FEE Yes No �/ PARK FEE <br /> SAC Yes No �� STTEINSPECT'ION <br /> Number of SAC�Units OTHER (specify) <br /> ZONING CH�CK LIST Zoning District: c� -t G <br /> Fire Department: Post Office: School District: � <br /> Lot Area: Sq:ft. Zo,?l43 Acres . �-i� � Width S 7•3 Depth 362.�� <br /> Survey Submitted: Yes�_ No Date of Survey: 2'�I-t�2 <br /> Proposed Setbacks: � <br /> Front(Lake): �b� (� Right Side: t� •$ 1 3 <br /> Ii.�ar(Street): 1 S I'� Left Side: Zg.7 ll7 <br /> Adjacent Structures: �-t`O S 2 Wetland: /V (q <br /> Building Height: Def. Hgt. e _�� Peal:Hgt. �r C. <br /> L.ot Coverage: G �5 <br /> Grading: Staff Approval Date: — By: Council Approval Date: <br /> Septic: Staff Approval Date: � By: <br /> Zoning File: # �Z- �7 �O Resolution: # Resolution Date: �--t..�'-�� <br /> Shoreland District: v-P S �. <br /> Avg. Setback: o•tL Bluff Setback: r/(/�- Lot Coverage: � �5 <br /> Existing Proposed <br /> Hardcover: 0-75' o � <br /> 75-250' �.� ��_ <br /> 250-500' �y ��, <br /> -n� <br /> 500-1000' <br /> Hazdcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />