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{ <br /> � +, ,�. , . _ �'��,-�C�eL- -��� � - �� - - <br /> CHECR OFF LIST FOR ISSIIANCE OF PSRMITS <br /> FOR OFFICE SE ONLY <br /> ADDRESS OR LEGAL:� OC� 1 � � PID: <br /> DESCRIPTION OF WORR: ._...> E ''���: <br /> -------------------:� .��--------------------- <br /> ------_---�-------_------------- <br /> ZONING REVIEW BY: ��� DATE APPROVED � �� �'� <br /> BIIILDING REVIEW BY:�� DATE APPROVED: � • Z.4 -y ( <br /> --------------------- --------------------------------------� ---------------- <br /> FEES TO BE CHARG$D: Misc. Fees Calculated By: � <br /> PERMIT xes �/ . No <br /> PLAN REVIEW :Yes� No SEWER CONNECTION -- <br /> STATE SURCHARGE Yes� No WATER CONNECTION r- <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: � d�'-- ` � �� <br /> Fire Department: �' r-'�� ��-- Post Office: �=��- School District:�"~�G�°,�l� '-� <br /> :� � � <br /> Lot Ar�a: `� � Width: ���' '� Depth: �CX� <br /> Survey Stzbmitted: : , ,�es� No Date of Survey: .S - 2-`7 -�� <br /> Proposed`�'Setbacks : , i � <br /> ��o�t- (Lake) : /�j'��� =` Right Side: � � <br /> ��r (Street ) :�2 �^ � Left Side: � '� . <br /> Adjacent Structures : — Wetland: --� <br /> Building Height: Def. Hgt. '" Peak Hgt. -� <br /> Avg. Setback: V�t' "'•,'�_t � �� �'' �`�� Lot Coverage: <br /> Existing Proposed <br /> nf <br /> Hardcover: 0-75 ' � � /� f' �� '� �'W �C� " <br /> 75-250 ' ' !:/`' �yr11 �^�" � Z�v , � � '� �� �, , � . �,,,,�r `� /��51� S,�n <br /> _ � v � <br /> �. G� ��• 1 <br /> �� �, , �' � ;_ � <br /> 250-500 ' ! % '" ^ <br /> 500-1000 ' <br /> Hardcover Variance Required: Yes ;"'T No Date of Council Approval: "Y' � '�7 <br /> Grading: Staff Approval Date: ' By: - Council Approval Date: ` <br /> Septic: Staff Approval Date: By: �`�" <br /> -�' y�`�'l f�` Resolution Date: �`' ` :�� ` �� <br /> Zoning File: #�S Resolution #: <br /> R�iARRS (in house) : <br />