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CHECR OFF LIST FOR ISSIIANCE OF PERMITS <br /> � ' FOR OFFICE USE ONLY <br /> ADD1tSSS OR LEGAL: �;� TQ�I'�e/7�,)D v� �0�-d� _PID: 05�l 1 7-�-3 �3 E�Y��--- <br /> D$SCRIPTION OF WORR: �-�-� � <br /> -------------------------------- <br /> ------------ ----------- <br /> ZONING REVIEW BY: DATS APPROVEU: 3- Z 3 `5 �"j <br /> BIIILDING REVI$W BY: DATE APPROV$D: 3 'Z 3 - 5 � <br /> FESS TO B$ CHARG�: Misc. Fees Calculated By: <br /> PERMIT Yes � No <br /> PLAN REVIEW Yes�/ No SEWER CONNECTION <br /> STATE SURCHARGE Yes ✓' No WATER CONNECTION <br /> INVESTIGATION FEE Yes No � PARK FEE <br /> SAC Yes No_� SITE INSPECTION <br /> Number of SAC Units OTHER .(specify) <br /> ------------------------------------------------------------------------------ <br /> ZONING CHECR LIST Zoning District: L�G-/L3 <br /> Fire Department: /YO C! Post Office: -- School. District: —' <br /> Lot Area: �{�,��o�� Width: ��,R•�qvc.�t- Depth: - <br /> --v <br /> _ Survey Submitted: Yes� No Date of Survey: 7-7-�� [ �`"�� ''� <br /> Proposed Setbacks:/3g� c1�+~�`" S�+•R�un� <br /> Front (Lake) t Sn� �x�^'��� aAYRi ght Side: N <br /> Rear (Street) : �lA Lef t Side: N �l- � <br /> Adjacent Structures: /�T't73Cd�F�'Z7 Wetland: N�A <br /> Bui lding Height: Def. Hgt. (�. ��- Peak Hgt. (�.IZ <br /> Avg. Setback: N�� Lot Coverage: S. 3 <br /> Existing Proposed <br /> Hardcover: 0-75 ' �j. �7 �a !( �o <br /> 75-250 ' <br /> 250-500 ' <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes�c No Date of Council Approva�: � '��`�Y <br /> Grading: Staff Approval Date: By: Council Approva� Date: <br /> Septic: Staff Approva� Date: By: <br /> Zoning File:# �SC �'7 Resolution #: Resolution Date: ,�'�Y' �Y <br /> RffiKARRS (in house) : <br />