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� � <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESSORLEGAL: 38ti5 /�torzri-t ��p2,E (JR�v� <br /> PID: I�- IJ-1- Z3 ZZ c000 � <br /> DESCRIPTION OF WORK: ' .r'��,p �n e,� — P c-r+asC �. <br /> ------------------------------------------------o S -- <br /> ZONING REVIEW BY: (.Q�.4.._ DATE APPROVED: � z.-3 7 <br /> BUII.DING REVIEW BY: DATE APPROVED: �z - 30•5 7 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓' No <br /> PLAN REVIEW Yes �- No SEWER CONNECTION <br /> STATE SUR�HARGE Yes _��' No WATERCONNECTI�N <br /> INVESTIGAT'ION FEE Yes No, PARK FEE <br /> SAC Y:;s No STTEINSPEG"TION <br /> Number of SAC Units OTHER (specify) <br /> � --i---- ----------------------------------------------------_M�« <br /> ZONING CHECK LIST zoning District: L2-r L <br /> Fire Department: M o u n1(J Post Office: W(,o��,/� School District: YYL n,1N,� _ <br /> Lot Area: Sq.ft. 2'1,4�8 5 Acres .(, 3 Width �3�8 Depth ��(��S <br /> Survey Submitted: Yes�C_ No Date of Survey: �'-1-2g- 9 7 <br /> Proposed Setbacks: � <br /> Front(Lake): _ b`�• Right Side: /`f0 �= <br /> Reaz(Sueet): ���` . Left Side: (�Z•� � <br /> Adjacent Structures: i4TT�'tGi�.c� Wetland: �l�/'►- <br /> Building Height: Def. Hgt. O.k. Peak Hgt. � <br /> Lot Coverage: D /3•L <br /> Grading: Staff Approval Date: /1!(.4- By: — Council Approval Date: — <br /> Septic: Staff Approval Date: �— By: -- <br /> Zoning File; # a 3�� Resolution: # Resolution Date: <br /> Shoreland Dis�ict: �2 S <br /> Avg. Setback: r(I�/�- Bluff Setback: N (/�- LotCoverage: l3 •�v <br /> � Existing Proposed <br /> Hazdcover: 0-75' <br /> 75-250' <br /> 250-500' $ <br /> 500-1000' 10"Za 30-�t <br /> Hazdcover Vaziance Required: Yes No v� Date of Council Approval: <br /> REMARKS(in house): P f�4�ASE � O F g���c�rNG Q��i r ��Y9Z <br /> ss� o c-�►� �" �i�19 Z <br /> � 26 <br />