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* CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> /� � PID: <br /> ADDRESS OR I,EGAL: 5 3� F��4��' L� _ <br /> DESCRIPTION OF WORR: L�I� s�'�2 S ------------------------- <br /> ------------- <br /> ----------- --------�------ : 5- a�-gs <br /> ---------- . DATE APPROVEll <br /> ZONING REVIEW BY: - ' . <br /> � DATS APPROVED: S' Z Z-`T S <br /> BIIIZ,DING REVIEW BY: _ ---------------------- <br /> ---------- <br /> ------------- <br /> FEES TO BE CHAFtGED' Misc. Fees Calculated By: <br /> PERMIT Yes t� No <br /> PLAN REVIEW Yes J' Na SEWER CONNECTION <br /> ✓No WATER CONNECTION <br /> STATE SURCHARGE `�eS Na pp,RK FEE <br /> INVESTIGATION FEE Yes gITE INSPECTION <br /> SAC Yes No <br /> OTHER (spe cif y) <br /> Number of SAC Units ------------------------ <br /> -------------- <br /> ------ <br /> ----------------------- <br /> ZONING CHECR LIST Zoning District: �( <br /> Fire Department: L L <br /> Post Office: (�L- School District: (�/�� <br /> /' ' �' Iq-v-Q <br /> Lot Area: 1 g U Zl, S 1- �r Width: �C�( �= Depth: l�fl <br /> Survey Submitted: Yes� No <br /> Date of Survey: g'"���5`f <br /> Proposed Setbacks : � � Right Side• l(��`� � <br /> ���t (Lake) : ifl ' <br /> �r- (Street) : /J �IQ- Left Side: ���� <br /> Adjacent Structures: <br /> �` -� WetJ.and: ��'4 <br /> N�/� P k Hgt. <br /> Building Height: Def . Hgt. ; <br /> Lot Cov rage: <br /> Avg. Setback: opo ed <br /> Existi g <br /> Hardcover: 0-75 ' <br /> 75-250 ' <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance equired: Ye <br /> N D e of Counc 1 Approval : <br /> Grading: Staff App oval Date: BY= <br /> Council pproval Date : <br /> Septi c: Staf f Ap_ roval. Date: B � <br /> Zoning Fi�e:# Res ution # Resolut on Date: <br /> �2F.I�(AR�C$ (in ho se) : <br />