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' CHECK OFF LTST FOR ISSUANCE OF PERi1�ITS <br /> � FOR OFFICE USE ONLY <br /> 'ADDRFSS ORLEGAL: _ :�`l� N��xt�t 5t�-o.�.c; ,�(l . <br /> PID: <br /> DESCRIPTION OF WORK: . (�,�p ,� �,vS � <br /> ZONIiYG REVIEtiY BY: � ~ � Y� DATE APPROVED: �-Il•Z-�i�8 - <br /> BUII�D .]NG REV7Eti� BY• . DA1E APPROVED: _ /t- 2.-�r�8 <br /> �EES TO BE CHARGED: • - � Misc. Fees Calculated By: ' � <br /> PERMIT -Yes ✓� No . <br /> PLAN REV�W Yes �/ No SEWER CONNEC'Ii0�1 <br /> STATE SUR`H1�RG� Yes ✓ No '��IATER CO�TECITON <br /> I7VYESTIGAZTON-FEE Yes No PARK FEE <br /> SAC Yes No SITEIlVSPECTION <br /> Number of SAC Units `OTHER (specify) <br /> --------------------------- ------ ---- <br /> ZO�LtiTG C�CK LIST Zoning District: C_EZ- �L � <br /> Fire Department: (_on.,�(/�� post Office: W�a.�-r�,r-q-,� School District: �j�6 �,u,� <br /> J <br /> Lot Area: Sq.fc._ �r o c�,� Acres tiVidth — Depth — <br /> Survey Submitted: Yes_ L� No Date of Survey: �,v ('t�,�s <br /> Proposed Setbacks: <br /> �roIIT(La.�Ce): . /�o� Right Side: S�Ut�t�t' l�� � <br /> $ea�(Street): / 7O � Left Side: Z3` � <br /> Adjacent Structures: `Vetland: /1/!� <br /> Buildino Hei�ht: Def. Hgt• Q,/�. Peak Hgt. — <br /> Lot Coverage: !2 �' <br /> GradinJ: Staff Approval Date: -- �y; — Council Approval Date: <br /> � <br /> Septic: Staff Approval Date: — gy; --�� . <br /> Zoning File: # � �-- Resolution: # Resolution Date:� • <br /> Shoreland Dis�ict: yr5 � <br /> Avg. Setback: _ NJ/} Bluff Setback: /�/(f) Lot Coverage; !Z�� <br /> ' ' Existing Proposed <br /> Hardcover: 0-?5' <br /> 75-250' . . 2 S°7o ' ' <br /> 250-5Q0' . . <br /> 500-1000' <br /> Hardcover Variance Required: Yes No,� Date of Council Approval: <br /> . Y <br /> RE�ZA.R.KS (in house): � <br /> z - � ' � <br /> : .,'' t, _ .26 . <br />