Laserfiche WebLink
� CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> � � FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: b�U PR� c.a-,.-e . <br /> PID: <br /> DESCRIPTION OF WORK: A qp�Tyt�� (?.t.'wwanc. , <br /> ZO.vl�Ti G $E'VIEW BY: ,. DATE APPROVED: �- i b -0 3 <br /> BUILDI�i TG REVIEW BY: DATE APPROVED; t-�e -0 3 <br /> FEES TO BE CIiARGED: Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAl�T REVIEW Yes ,.� No SEWER CONNECTION <br /> STATE SURCHARGE Yes v No WATERCONNECTTON <br /> INVESTIGATION FEE � Yes No PARK FEE <br /> SAC Yes No � SITEINSPECTION <br /> Number of SAC�Units OTHER (specify) <br /> ZONING CH�CK LIST zoning Districr. <br /> Fire Department: Post OfFice: School District: • <br /> Lot Area: Sq�.ft. Zo,s�2� Acres � Width Depth <br /> Survey Submitted: Yes_ !� No Date of Survey: � • 1/•I 3-oZ <br /> Proposed Setbacks: � <br /> Front(Lake): S D Right Side: I Z .(, <br /> Rear(Sueet): 3`�l•1 Left Side: 1 V.'i- <br /> Adjacent Structures: __�l,f► Wetland: N �r° <br /> Building Height: Def. Hgt. 2`�•S Peak Hgt. 33 <br /> Lot Coverage: /0�o � <br /> Gradina: Staff Approval Date: /- !�- 0 3 By: c7�°' Council Approval Date: <br /> Septic: Staff Approval Date: N 1/� By: <br /> Zoning File: # ^ Resolution: # r- Resolution Date: �-- <br /> Shoreland District: �,e s <br /> Avg. Setback: _ N 1/� Bluff Setback: �•l 1/� Loc Coverage: �o°7d � � <br /> Eaisting Proposed <br /> Hazdcover: 0-75' <br /> 75-250' 0 9• z t- <br /> 250-500' Z i.4� i;.�3 <br /> 500-1000' <br /> Hardcover Variance Required: Yes No�_ Date of Council Approval: <br /> REMARKS(in house): <br /> 7 <br />