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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �-�{ �l � � �yQJ Z Permit No.:_ �17 "D�tN� <br /> Description of work: _��C/vV 1'�� Date Rec'd: �' ('T'� � <br /> Septic review by: �(�(if/�(�l'' Q� �V c.�`f�/� Date Approved: <br /> Zoning review by: � ' Date Approved: `�'� � r� <br /> ," ; � �- <br /> Building review by: �1 r'��� � .�( � > Date Approved: � � l <br /> �� <br /> Grading review by: f�l�l'l �UVbI!(N► (J�'I , Da "nnroved: �' � �� ( <br /> ���.�`',�_ <br /> Zoning District: u Zoning File#: ��� <br /> Resolution? Yes Reso#: Reso Date: /a �lution/NA <br /> Zoning: Lot Area: <br /> Q�.J AC Width: �J�C��/7/ T f�` `SF �_` �n % <br /> -�dt /, <br /> Survey Submitted: �es � No Date of Survey: _ ��r • �te � : �'��D'� <br /> Landscape plan submitted? � Yes Landscaper: Y1 U► ��� No/ one proposed <br /> �fMl �� Y'�/ i�— . <br /> Pro osed Setbacks: si <br /> � <br /> Front(L�� Rear(SJ� ( N S� E W� (� S E W�� Other Buildings Wetland <br /> � Side Side <br /> � � �C�f � -7, � <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and defined Top of �a� � <br /> Roof* See "buildin hei hY' definition : <br /> First Floor Elevation from buildin lans : (b) �(� . ,t` <br /> Highest Existing ground level (per survey) or 10' <br /> above lowest round level, whichever is lower: ��� ��'%�� <br /> Difference between b and c : (d) �,� , <br /> DEFINED HEIGHT If highest existing grade is: (@� ���,(Y <br /> -��above FFE-Height is(a)-(d) <br /> below FFE-Height is(a)+(dl <br /> Shoreland District MCWD Permit Average Lakeshore Setback gluff <br /> Met? <br /> Yes � No Permit Number: �, � 0 Yes � No �/A � Ye No <br /> 0 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 /> �(�.�QZ� 0 Yes No � Yes No <br /> 1 2 3 04 5 � Type(s): Type(s): <br /> �Z S-� <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />