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CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> R OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ' (A10, 1&.14# <br /> PID: <br /> DESCRIPTION OF WORK: 4`rfAI'l e. l/YlC41C44/14 i'7 <br /> ZONING REVIEW BY.�_________ DATE APPROVED: l�-2.q-Q <br /> BUILDING REVIEW BY: cge. .,,, DATE APPROVED: (I-a©.p,c, <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ✓ No <br /> PLAN REVIEW Yes r - No SEWER CONNECTION <br /> STATE SURCHARGE Yes ,/ No WATER CONNECTION <br /> INVESTIGATION FEE Yes No ,/ PARK FEE <br /> SAC Yes No V SITE INSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ZONING CHECK LIST Zoning District PF e) <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sgft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: pN F1 LAI <br /> Proposed Setbacks: <br /> Front(Lake): Right Side: <br /> i <br /> Rear(Street): 5 Left Side: <br /> Adjacent Structures: IC-froologUll 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: ND MCWD Permit: <br /> Avg. Setback: Bluff Setback: 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): /y«S Gu 411'-iv IAA- A �tfooh q," 1115p2.c,Iw"h 4D <br /> TV) S -Ihis.. AYL. in • vigil 1- pl gem. Arid AL. dl( anemia <br /> o7 f S we've- -11,1.4441 (Z4 f' '. <br />