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' � � <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �(33o No� 5l-�0� �/�, <br /> PID: <br /> DESCRIPTION OF WORK: �,��o/)-o�. <br /> ------------------------------------------- -- --------------------------------------------------------------------- <br /> ZONING REVIEW BY: D�TE APPROVED: ��� <br /> BUILDING REVIEW BY: DATE APPROVED: K �Zr � <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 SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: /�� %�- � � <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Si e: <br /> Rear (Street): Left Si : <br /> Adjacent Structures: Wetland: <br /> Building Height: Def. Hgt. Peal:Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff etback: L.ot Coverage: <br /> Existi Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes o Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />