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<br /> ,.'y CHECK l?FF LIST FOR ISSUA:tiCE OF PERi�IITS
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<br /> "�" ,�:�, � IONLti'G REV���' BY: ��;" CQ�w,� DATE�,PPROVED: Q � �a 4 5
<br /> .w' :" � ,' `; �UII,DL�G REVIE�V BY: '' DATE APPROVED: � �2 <,�
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<br /> i; ` FEES TO BE CHARGED: Misc. Fees Calculated By:
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<br /> PER1�fIT Y'es ✓ N<�
<br /> �"r �� �t��`� PLAN REVIEW Yes ✓ N�� SEWERCONNECITON
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<br /> 4�*� STATE SURCHARGE Yes ✓ ��� WATER C01�'NECITON
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<br /> '�,G J�i,,�"�k'',,�' INVESTIGATION FF,E Yes ti'.� ✓ PARK FEE
<br /> �� SAC Y'es N � _ ✓ SITE INSPECTION
<br /> Number of SAC Units OTHER (specify)
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<br /> ZONING CHECK LIST Zonine District: �r•I� Shoreland Distria: �es
<br /> ;«,,�'� rr4�k` a'm�Y€t�; Fire Dep:utmrnt: t_(, Post Office: �v�.y�_4-tt School D�stricc: �l�.c�vv
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<br /> t Front (L:ike): �U�µ� Right Side: I`10_�+�
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<br /> ' �!�3 �„ �x ,� Hardcover: 0-75'
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<br /> � :;•',��� �� 500-1OQ0'
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<br /> � ' ' ° Hatdcover Variance Required: Yes No_� Da�e of Council Approval: _
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<br /> "' .:.�� �� Septir. Staff Approval Date: r�'�"�-5 K By: S.�J
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<br /> Zoning File: � Resolucion: x — Resolution Date: '—
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