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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> R OFFIC psE <br /> ADDRESS OR LEGAL: 7J co (i'j,s <br /> PID: <br /> DESCRIPTION OF WORK: Al-&--' Ytc <br /> ZONING REVIEW BY: , �`�/f > DATE APPROVED: 3-e``f <br /> BUILDING REVIEW BY: � : j DATE APPROVED: 3- •% <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes No <br /> PLAN REVIEW Yes � die SEWER CONNECTION <br /> STATE SURCHARGE Yes �' No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � FEE <br /> SAC Yes No . SITE iNSPEC ION <br /> Number of SAC Units OTHER (specify) / <br /> ZONING CHECK LIST Zoning District: Rk-/ Shoreland District: 3"' <br /> Fire Department: Ili . ' Post Office: r chool District: e--2 g <br /> Lot Area: Sq.ft. ft, a. Acres Width 3 Depthglu <br /> Survey Submitted: Yes V No Date of Survey: <br /> Proposed Setbacks: 1 )) /I / <br /> Front (ice). 33 Right Side: //i` ' <br /> Rear (WE): )61 / Left Side: q/i{j <br /> Adjacent Structures: <br /> Wetland: 5/ <br /> Building Height: Def. Hgt. ,)� Peak Hgt. <br /> Avg. Setback: 414- Bluff Setback:t/ "'2 Lot Coverage: 14 <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' N.0. <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No oC Date of Council Approval: <br /> Grading: Staff Approval Date: 3-4:8 -IL. By:/CZ Council Approval Date: <br /> Septic: Staff Approval Date: 3 g /W By: 131.. <br /> Zoning File: # — Resolution: # Resolution Date: , <br /> REMARKS (in house): <br /> • <br /> 26 <br />