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�\ <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: I`-��{1 P�121� [�R 1 V� <br /> PID: <br /> DESCRIPTION OF WORK: 1��f� �-t-� o�► 2r�c1� ��!� <br /> --------------------------------------- -------------------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: �z _�� -y� <br /> BUILDING REVIEW BY: DATE APPROVED: i z- iY-�i�'� <br /> FEES TO BE CHARGED: Misc. Fees Calculated By: <br /> PERMIT Yes ,/� No <br /> PLAN REVIEW Yes i/��o SEWER CONNECTION <br /> STATE SUR`HARGL Yes No WATERCONNECTION <br /> INVESTIGA'I'ION FEE I'es No PARK FEE <br /> SAC Y.;s No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: L�� '►�-'' <br /> Fire Department: �%�,�(o�.�f.�eJ� Post Office: V vt,t,,.,�t' School District: �.�--���.v.� <br /> Lot Area: Sq.ft. �b ,YS�d� Acres •'_��d � Width 5�• �� �- Depth �g S.� } <br /> Survey Submitted: Yes ,� No Date of Survey: Z-'� � ��� <br /> Proposed Setbacks: <br /> Front (Lake): l 2�� �- Right Side: Z 3, � <br /> Rear (Street): ( 3�� � Left Side: 3�`1 � <br /> Adjacent Structures: J�; 1�� Wetland: � �1�� <br /> Building Height: Def. Hgt. � . � Peak Hgt. ~— <br /> Lot Coverage: �'�C ('.j��v��C <br /> Grading: Staff Approval Date: /l,f�C- By: — Council Approval Date: "-` <br /> Septic: Staff Approval Date: � By: — <br /> Zoning File: #i Z�3Y b Resolution: # yCSv Resolution Date: ;� �3 `> � <br /> Shoreland Dist_�ict: �.y{�� ` <br /> Avg. Setback:� v.1� Bluff Setback: lV (l�- LotCoverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' N�,, C�/UC7L <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No '� Date of Council Approval: <br /> REMARKS (in house): <br /> 26 <br />