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, �HE�J[� OFF i�IST FOR ISSUANCE OF �ER�.tiiITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: ��� � �� � �`� �`'�"`� <br /> PID: <br /> DESCRIPTION' OF WORK: 'v](�� N�/ ;'��"'c�c�� �/��9 <br /> ------------------------- <br /> ZOV�IG REVIE`V BY: ------ l�'w /� !� z� DATE APPPtiOVED: Z <br /> SUII�DING RE'VIEtiV BY: . . DATE APPROVED: 7. 2 - <br /> ----=--------- ---- ---------------------------=-----------------------o------- <br /> F`EES TO BE CHARGED: Misc. Fees Caiculated By: <br /> PERMIT Yes � No <br /> PLAN REVIE`V Yes � No S�VER COVNECTION <br /> STATE SURCHAR.GE Yes —� No `VAT'ERCONNECTTON <br /> INVESTIGATION FEE Yes No .� PARK FEE <br /> SAC Yes No ✓ STTEINSPECTION <br /> Number of SAC�Uruts OTHER (specify) <br /> ZON'L�IG C�iE.CK LIST Zoning Districc: N� t �. <br /> Fire Department: Post�ffice: School District: � <br /> I,ot Area: Sq.ft. Acres � Width DepCh <br /> Survey Submitted; Yes No Date of Survey: <br /> Proposed Setbacks: � <br /> Froat(Lake): Ri�t Side: <br /> Rear(Street}: Left Side: <br /> Adjaceat Strucrures: � ttand: <br /> Suil�lin�Height: Def. Hgt, Fe Hgt. <br /> Lot Covera�e: <br /> Gradino: Staff Approval Date: By Council Approval Date: ' <br /> Sepcic: Stzff Approval Date: rV� �Y� l-'�� <br /> Zo�n� File: � Resolutioa: � Resolution Date: <br /> Shoreland District: <br /> Av;. Setback; Bluff Setback: � - L.ot Coverage: <br /> Evstin� Prcposed <br /> D <br /> Hardcover: 0-75' <br /> 75-250' <br /> 2�Q-SGO' • � <br /> 500-l OC`0' . <br /> �iz:�.c�4�zr V�iance P.equi;ed� Yes `�o Dac_ o` Cc�u.cil Approvz_': <br /> F.E�L��s (L_rousel; <br />