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� . <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: /�/,3 S �O/,i/1�� pR� �� <br /> PID: <br /> DESCRIPTION OF WORK: �TA i�1. d f= ,gn,q�t <br /> ZONING RET�IEW BY.• '�r^ DATEAPPROVED: /�•3- o g <br /> BUILDING REVIEW BY.• DATEAPPROVED: /� -3- v� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes_� No <br /> PLAN REVIEW Yes No � SEWER CONNECTION <br /> STATE SURCHARGE Yes_�.C' No WATER CONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (spec�) <br /> ZONING CHECIC LIST Zoning District: C �� <br /> Fire Department: Post�ce: 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 Side: <br /> Rear(Street): Left Side: <br /> Adjacent Structures: N�e and.• � <br /> Building Height: Def. Hgt. P ak Hgt. <br /> Lot Coverage: <br /> Grading.• Staff Approval Date: By: Council Approva!Date: <br /> Septic: StaffApprovalDate: y; <br /> Zoning File: # Resolution: # Resolution Date: <br /> Shoreland District: MCWD Permit: <br /> Avg. Setback: BluffSetbac • LotCoverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 2.i 0-.i 00' <br /> 500-1000' <br /> Har•dcover �'ariance Required: Yes No Date of Council Approval: <br /> REMARKS(in house): <br /> 33 <br />