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� <br /> CHECK OFF LIST FOR ISSUANCE OF PERMITS <br /> FOR OFFICE USE ONLY <br /> ADDRESS OR LEGAL: i I t�O PI-� 1��t PS <br /> PID: <br /> DESCRIPTION OF WORK: =2 -c�c� G�lx c. <br /> --------------------------------------- ------- --------------------------------------------------------------------- <br /> ZONING REVIEW BY: DATE APPROVED: `� -�O -�7� <br /> BUILDING REVIEW BY: — DATE APPROVED: <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> FEES TO BE CHARGED: �/1,���q Misc. Fees Calculated By: <br /> PERMIT Yes �/J No <br /> PLAN REVIEW Yes � No SEWER CONNECTTON <br /> STATE SURCHARGE Yes No WATERCONNECTION <br /> INVESTIGATION FEE Yes No PARK FEE <br /> SAC Yes No SITEINSPECTION <br /> Number of SAC Units OTHER (specify) <br /> ------------------------------------------------------------------------------------------------------------------------ <br /> ZONING CHECK LIST Zoning District: /�,�v C..(.:�� <br /> Fire Department: Post Office: School District: <br /> Lot Area: Sq.ft. Acres Width Depth <br /> Survey Submitted: Yes No Date of Survey: <br /> Proposed Setbacks: <br /> Front (Lake): Right Side: <br /> Rear (Street): Left Side: <br /> Adjacent Structures: Wetl d: <br /> Building Height: Def. Hgt. Peal: gt. <br /> Lot Coverage: <br /> Grading: Staff Approval Date: By: Council Approval Date: <br /> Septic: Staff Approval Date: By: <br /> Zoning File: # Resolution: # esolution Date: <br /> Shoreland District: <br /> Avg. Setback: Bluff Setback: Lot Coverage: <br /> Existing Proposed <br /> Hardcover: 0-75' <br /> 75-250' <br /> 250-500' <br /> 500-1000' <br /> Hardcover Variance Required: Yes No Date of Council Approval: <br /> REMARKS (in house): <br /> 7 <br />