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' CHECR OFF. LIST FOR ISSUANCE OF PERMITS <br /> FOR OFF�CE USE ONLY <br /> ADDRESS OR LEGAL: �3�,�� �, �(,t� ���' PID: <br /> DESCRIPTION OF WORK:��� {��IC� t �.� <br /> ----- -------------------------------- <br /> -------------- --- - - --- <br /> ZONING REVIEW BY: ���,� DATE APPROVED: , ;J �/ `��� <br /> / <br /> BIIILDING REVIEW BY: � DATE APPROVED: � " � <br /> ------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ��� No <br /> PLAN REVIEW Yes �= No SEWER CONNECTION <br /> STATE SURCHARGE Yes l' No WATER CONNECTION <br /> INVESTIGATION FEE Yes No �/ PARK FEE <br /> SAC Yes No �/ SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------ <br /> ZONING CHECR LIST Zoning District: L� li <br /> Fire Department: ��� Post Office: /J//,��,,.,� Schoo� District: /'� � <br /> Lot Area: J �, � �'� Width: �(�j) � � Depth: <br /> Survey Submitted: Yes� No Date of Survey: <br /> Proposed Setbacks : , , <br /> � (Lake) /���A Right Side: � �3,� - <br /> � <br /> Re�-� (Street) : �C� � Left Side:�'�,�� ��"�_` <br /> Adjacent Structures : f� {� �%r Wetland: j�%�r� <br /> -� <br /> Bui�ding Height: Def . Hgt. iv��I Peak Hgt. /�� ��� <br /> Avg. Setback: /�'/�1� Lot Coverage: � <br /> Existing Proposed <br /> Hardcover: 0-75 ' <br /> 75-250 ' L�' i 5�� <br /> 250-500 ' � <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes NoL�_ Date of Council Approval: <br /> Grading: Staff Approval Date: � � By:� Coun�il Approval Date: <br /> Septic: Staff Approva� Date: % �y: <br /> / <br /> Zoning File: # Resolution #: Resolution Date: <br /> REMARRS (in house) : <br /> r <br /> r <br />