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i <br /> PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: ���� IJIU �a�� �_i Permit No.: ���7 ' O�Z� <br /> Description of work: ���YVII �� � �g ��1 �' lY� Date Rec'd: ��'3'�� <br /> ��/ .,._---- <br /> Septic review by: ��,1�`� Yv Q Date Approved: <br /> Zoning review by: Date Approved: ��'�lV'�� <br /> Building review by: Date Approved: f 0 �� `T <br /> Grading review by: �,` �W ar� Date Approved: ��• �0 '� / <br /> Zoning District: � Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes o Resolution/ <br /> Zoning: Lot Area: l�� S /AC Width: Structural Coverage: SF °/a <br /> Survey Submitted: �es � No Date of Survey: �' �•l 1 Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: �'�7 S r UNv In 0 No/None proposed <br /> Pro osed Setbacks: <br /> F nt(Lake) R (Street) ( f�S E W ) ( N� E W ) Other Buildings Wetland <br /> v Side �•�de <br /> r�,.,, ► � <br /> Buildin Hei ht Anal sis: <br /> Distance Between First Floor defined Top of Roof (See"building heighY' �a� <br /> definition : <br /> First Floor Elevation rom buildin lans : (b) <br /> Highest Existin�ound level (per survey) or 10' above lowest ground level, ��� �� <br /> whichever is,lcfwer: <br /> Differenc etween b and c *: (d) <br /> D INED HEIGHT <br /> *If highest existing adjacent grade is above FFE-Height is(a)-(d): (e) <br /> "If hi hest existin ad'acent rade is below FFE-Hei ht is a + d <br /> Shoreland District MCWD Permit Average Lakeshore Setback gluff <br /> Met? <br /> �Yes � No Permit Number: �� -3i�- 0 Yes 0 No � N/A � Yes No <br /> � N/A—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and s % and s <br /> �•3$�U �•(���0 0 Yes o 0 Yes o <br /> � 2 3 4 5 Type(s): Type(s): <br /> i2�4�osf i3, c��5 s� <br /> Updated: June 2017 <br /> z:\forms\plan review checklist 06-2017.docx <br /> i � i i <br />