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• -, <br /> C�IEC�. ��' I-�T FOR ISSUAriCE OF � .��IITS <br /> FOR OFFICE USE ONLY <br /> �DDRESS OR LEGAL: 13°'�O 1�AR�z 'p� <br /> PD: <br /> DESCR�'TION OF WORK: N CW �� '_� <br /> ZONING REVIEW BY: DATE APPROV�D: � .Zq-�c. <br /> BUZLDu�`G REV�tiV BY: DATE APPROVID: 7- 2�(-�'� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERTv1IT Yes ✓' '`lo <br /> P�N ��� YeS ,/-, v o SEWER CONNEC'I'ION <br /> STATE SL"RCHARGE Yes �N° w�T� CO�tNECI'ION <br /> INVESTIGATION FEE Yes No ✓ PARK FEE <br /> SAC Yes No �/ SITE INSPECTION <br /> Number of SAC Units c_t�-'iO'.T r��`- �4A� �THER (speciry) <br /> - ------ <br /> ZO�`�L�G CHECK LIST Zonin�District: L/'L-► � Shoreland Distnct : y-P� — <br /> Post Ofiice: �M�J N � �chool District: i��ilN� <br /> rire Departr,�ent: M ov nJ� � <br /> Loc?�rea: Sq.ft. 11, <br /> Zc�� Acres .`'1 Width 12R�(a��"?- Depth lU !� <br /> Survey Submitted: Yes � <br /> �,To Date of Survey: � "�� ��� <br /> Proposed Secbacks: i <br /> Front (Lake): 35 Ri;ht Side: LJO .b !�l <br /> Rear (Streec): �7� �' Left Side: � � <br /> Adjacenc Structures: r'3- Wetland: !J � h <br /> Buildin? Heighr. Def. Hgt. �Z� Peal: H�. � � <br /> Lot Covera e: �O /" <br /> Av�. Setback: (/� ) � _BluffSetback: I� �� g <br /> Ezisting Proposed <br /> Hardcover: 0-75' _ <br /> 75-250' — <br /> 250-500' C'h <<- <br /> 500-1000' <br /> �; �_ Date of Council Approval: <br /> Hardco�er Variance Required: Yes 1 o <br /> �/ �/.� B Council Approval Da[e: <br /> Grading: Staff Approval Date: Y� <br /> Sepdc: Staff Approval Date: � �� By� <br /> Zonin; File: n Z�`'�g Resolucion: � <br /> Resolution Date: � ' Z3'`�� <br /> RF1�tARKS (in house): !s.t v-e �4;�/�c�f� r�o �'i= �"t' �•v r�24 c�o 2 <br /> 3. <br />