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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESSOR LEGAL: Z`4 9 6 O L Y3 C3E YaGI.1 l� <br /> PID: _ <br /> DESCRIPTION OF WORK: i —yvta�/�2 L (� �i-u.teti G + S New win«Dours <br /> ZONING REVIEW BY: N k r�- DATE APPROVED: <br /> BUILDING REVIEW BY: DATE APPROVED: 6- <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes i,- No SEWER CONNECTION <br /> STATE SURCHARGE Yes t/ No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No STTEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District: N D 0411 N(o-p <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. Peak 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 Set 3aCk: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 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 />