Laserfiche WebLink
CHECK OFF LIST FOR ISSUANCE OF�ER1ti.tITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �(C}(�� �—I � • � ��� � � , � <br /> PID: <br /> DESCRIPTIO:V OF W'ORK: OC ' � � �' <br /> --------------------------------------------------j--------------------------------------------------------------------- <br /> ZONING REVIE lv B Y: �/ , DATE APPRO VED: <br /> B UILDIrVG.RE V.IE W B Y: � DA TE APPR O ti'ED: <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: Nlisc. Fees Calculated By: <br /> PERNIIT Yes No <br /> PLAN RET/IEIV Y"es �Vo SEYVER CONNECTION <br /> STATE SURCH4RGE Yes 1Vo � YVATER CONIVECTION <br /> IIti�VESTIGATI0IV FEE Yes !Vo PARK FEE <br /> SAC Yes tVo SITE NSPECTIO�V <br /> NL�»�ber of SAC U�zits OTHER (specify) <br /> --------------- --- - -------------------------------------------------------------------------------------------------- <br /> Z0IVING CHECIi LIST Zar�i�2g District: �� ' <br /> Fire Deparhne�rt: Past Office: School District: ___.. <br /> Lar.�lrea: Sq.f't. Acres Yt�i�fth Dept{i <br /> Survey Sc�br�iitted: Yes� Na Date of Sccrvey: � � ' �S ,bU��l�I�i' <br /> h�S� <br /> Proposed Setbacics: S�� C�>� i / <br /> Frortt(�= 1�1 oL i�'tgf�t Side: I�11'\ l� <br /> Rear(Street): Left Side: <br /> Adjace�zt Str•uct«r•es: G[�etla�id: <br /> Buildi�rg Height: Def. Hgt, Peak Kgt. <br /> Loc Coverage: <br /> Gr�adi�ig: Staff,4pprovccl Date: By: Cocuicil App��oval Date: <br /> Septic: Staff,4pproval Date: gY,� �� <br /> � <br /> Za�irig File: # Resolutiora: # Resolu[i� � -'� <br /> / � C <br /> / � <br /> Slcoreland Dish•ict: \/ <br /> Avg. Setback: Bl��ff Setback: t.,,> � <br /> Elistiiig �� <br /> Harcfcover: -8�— � <br /> -�'SO' � <br /> 250-500' (�^s 1`�--�`it� -r-� `-c-- (, <br /> 500-1000' 5��,"S '�` <br /> ' � 1 Karcfcover f/arianceReqc�i�•ed: Yes No � �� ��( `�d� 5__-P , ,. <br /> RE�l�fARKS(i�s lxoccse): <br /> 3i <br />