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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �v Permit No.: ��1 '' ��� <br /> Description of work: �� � �I a� Date Rec'd: � � ��� �� � <br /> Septic review by: Date Approved: -----• <br /> Zoning review by: Date Approved: ��' � ' � <br /> Building review by: Date Approved: �� �� <br /> ..-------.. <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/NA <br /> Zon�; Lot Area: SF/AC Width: Structural Coverage: SF % <br /> ���� <br /> e : � Yes � No Date of Survey: Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Buildin Hei ht Anal sis: <br /> Distance Between First Floor and defined Top of Roof* building height" �a� <br /> definition : <br /> First Floor Elevation from buildin lan : (b) <br /> Highest Existing ground level survey)or 10' above lowest ground level, ��� <br /> whichever is lower: <br /> Difference between and c *: (d) <br /> DEFINE EIGHT <br /> "If high t 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 Per ' Average Lakeshore Setback g�uff <br /> Met? <br /> � Yes 0 No Permit Numbe � 0 Yes 0 No /A � Yes �lo <br /> � N/A– e 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 /> � Yes �No � Yes No <br /> 1 2 3 4 5 — Type(s): Type(s): <br /> f_" <br /> Updated: June 2017 <br /> z:\forms�plan review checklist 06-2017.docx <br />