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. • ' I \ � <br /> � � <br /> � CHECK OFF LIST FOR ISSUANCE OF PERMITS . <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: �t�t Z 3 N• S. /J . - <br /> PID• <br /> DESCYtIPTION OF WORK: (3�rt�ow. �x�.gr�s c u•�J - <br /> ZONING REVI�W BY: DATE APPROVED: '�-�-F9 <br /> BUII.DING.REVYEW BY: DATE APPROVED: . 7-� -s�1 <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERNIIT Yes �' No <br /> PLAN REVIEW Yes � No SEWER CONNECTION <br /> STATE SURCHARGE Yes -� No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: �vo Gf�r,�,Q <br /> Fire Department: Post Office: School District: <br /> I.at Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes � No Date of Survey: O/v (��LL <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> Reaz(Street): Left Side: <br /> Adjacent Structures: Wefland: <br /> Building Height: Def. Hgt. Peak Hgt. <br /> •_ Lot Coverage: <br /> �� <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 Setback: 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 /> REMARI�S('m house): <br /> 7 <br />