Laserfiche WebLink
, � <br /> _ � ...�'�eea„� <br /> ,.��� <br /> CHECK OFF LIST FOR ISSUANCE OF PERctiIITS �';`;� <br /> FOR OFFICE USE ONL Y <br /> ADDRESS OR LEGAL: 35�� 1'v�RM ���u- `�R. <br /> PID: <br /> DESCRIPTIO.V OF YVOR.£f: NCI� 2�,5 — <br /> -------- ------- ------------------ ---------------------------------------------- <br /> ------------------------------------ ^(� - <br /> ZONI�VG RE vIE GF�B Y: (SLw.�-- D.�.TE APPROVED: !-��r-os <br /> BUILDIIVG REVIEYi�BY: DATEAPPRO�'ED: i- i�i-05 <br /> --------------------------- - <br /> FEES TO BE CHARGED: IL'Iisc. Fees Calctclated By: <br /> PERII�IIT Yes �/ No <br /> PLAtV RET/IE6V Yes _�� �Vo SEYVER CON�VEGTIOtV <br /> STATE SURCH,4RGE Yes � No tiVATER GO�Wt FCTI0IV <br /> ItVVESTIG,4TIO�V FEE Yes 1Vo ✓ P�tRK FEE <br /> SAC Yes �Vo � SITE NSPECTIOtV <br /> Number• of SAC Units ?2'�s�SFe/t Fitarti D�..� OTHER (specify) " <br /> --------------------- <br /> ----------��R_w�_=--�--5�'83--[�_��_?�--------------------------------------------------- <br /> 2'OrVING CHECh'LIST Zo,«,��otsr,�tcc: �2-r�- <br /> Fi1•e Departlrterrt: Post Office: Scltool Districf: __.. <br /> Lot.�ren: 5q.f't. 1 �,DO c� Aa�es .23 G�idtli SD Deptl� Zp� <br /> S�uvey Subfuitted: Yes DC No Date af Scuvey: <br /> Proposed Setbacl;s: <br /> Frait(Gake): I 1 Z Right Side: 10 <br /> Ren�•(Sh•eet): `'1 1 Left 5ide: � � <br /> Adjacent Str•uctures: Z.o G�etland: N/I� <br /> Building Height: Def. Hgt. _�� 2V Peak Kgt. — L�.� <br /> Lot Coverage: i5 0� � <br /> Gi•ading: Staff.4pprovctl Date: I- I'�-c�s By:�_ Coc�nci!rlppr•oval Date: ' <br /> Septic: Stnff.�{pp�•ot�af Date: ��� BY� <br /> Zating File: # H_30�4 Resolutiat: # Resolutio�i Dnte: �1-� '�� <br /> Shoreland Dish•ict: <br /> Avg. Setbac : �,t9 Bluff Setbncic: �1� Lot Coverage: �J� <br /> Existing Proposed <br /> Hardcover•: 0-7.i' <br /> 75-2�0' ZS°'T6 � °�° <br /> 250-500' 30 ' <br /> 500-1000' <br /> Hardcover T/a�•iarice Reqti�ir•ed: Yes�_ No Date of Cocuacil Approval: /!- -0 <br /> RE1I�IARKS(i�t house): <br /> 31 <br /> �� ,:.. <br /> '�,, �� ii ;��' ,'1, '.��� H'I iii' i�i �Id. -1i1 li ,� � � t � �� <br /> s <br /> �� � i� �� If '�i ,o^� , ;�ri �b t�.�; �u� i�i ��i � �U�r� Uf4�i ��i�l� <br /> ?� * � <br />