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. � ' . • <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY . <br /> ADDRESS OR LEGAL: V 365 rls o 2rN 5 tto�'r�c. �2. <br /> PID• <br /> DESCRIPTION OF WORK: Fc ns�sc-t (�o ti��� o r �w� C.c�—u-e.� <br /> ZO�TING REVIEW BY: DATE APPROVED: <br /> BUII..DING REYIEW BY: DATE APPROVED: y-2�-a3 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes v No <br /> PLAN REVIEW Yes ✓' No SEWER CONNECTION <br /> STATE SURCHARGE Yes �/ No WATERCONNECTTON <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No� SITEINSPECTTON. <br /> Number of SAC Units OTHER (specify) <br /> ZO�'ING CHECK LIST Zoning District: �°�'v ��� <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 Sid : <br /> Reaz(Street): Left Side: <br /> Adjacent Structures: etland: <br /> Building Height: Def. Hgt. P ak Hgt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: y: Council Approval Date: <br /> Septic: Staff Approval Date: y: <br /> Zoning File: # Resolution: # Resolution Date: . . . <br /> Shoreland District: <br /> Avg. Setback: Bluff Setbac : Lot Coverage: <br /> Existing Proposed <br /> Hazdcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS ('in house): <br /> 7 <br />