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_ _. �-�. _ <br /> � <br /> ` CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRFSS OR LEGAL: ��� � �C,��'`�t✓ �,/_�r--�- ,(}`�� _ <br /> PID. � '/ 'r/ i ./ J � `I �Ll C' / <br /> DESCRIPTION OF WORK: r'C���-� -�r��--� — <br /> ----------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: S• 8•� � <br /> BUII.DING REVIEW BY: DATE APPROVID: S'-�-9 G <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 � No WATER COrfNECTION <br /> INVESTIGATION FEE Yes No �-� PARK FEE <br /> SAC Yes No �---� SI'TE INSPEC"I'ION <br /> Number of SAC Units OTHER (specify) <br /> -------------------------------------- ______--- <br /> ZONING CHECK LIST Zoning District: C..Q`I 3 Shoreland District : y�_ <br /> Fire Department: 1'ti'l�J�'ti1i0 Post Office: ��` ,v,/� School District: t.vPS-rt�vl�h <br /> Lot Area: Sq.ft. �ob,S�� Acres � �SZ Width �►2R-c.��'c�/L Depth — <br /> Survey Submitted: Yes _� No Date of Survey: .S - 9-S i <br /> Proposed Setbacks: � <br /> �� ri_�e): y� = Right Side: (�1. ( <br /> � <br /> Rear (Street): Z 2 2- .� Left Side: n/���' <br /> Adjacent Structures: �}r�Cl� =� Wetland: �/J� <br /> Building Height: Def. Hgt. C?- l� Peak Hgt. (�.(� <br /> Avg. Setback: /l�f/�- Bluff Setback: i1l�/}- Lot Coverage: '' <br /> Existing Proposed <br /> Hardcover: 0-75' 2 • g Z•� <br /> 75-250' ! �t• "z- z N�� <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No �� Date of Council Approval: <br /> Grading: Staff Approval Date: /1///� By: Council Approval Date: <br /> Septic: Staff Approval Date: /���" BY� <br /> Zoning File: t� Resolution: # Resolution Date: <br /> REMARKS (in house): <br /> 26 <br />