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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: � �0 f�Y"' Permit No.: �� 1 "�� l � / <br /> Description of work: Iv �� S � Date Rec'd: � I �« �� ! <br /> Septic review by: ----^ Date Approved: ''—~ <br /> Zoning review by: Date Approved: � � �� � � <br /> Building review by: Date Approved: �� <br /> Grading review by: �---� Date Approved: '—� <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution /NA <br /> Zonin�q• Lot Area: SF/AC Width: Structural Coverage: SF % <br /> `��� . � Yes � No Date of Survey: Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: � 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* (See"building height" �a� � <br /> definition : <br /> First Floor Elevation from buildin lans : (b) <br /> Highest Existing ground level (per su or 10' above lowest ground level, ��� <br /> whichever is lower: <br /> Difference between b c *: (d) <br /> DEFINED H HT <br /> "If highe xisting adjacent grade is above FFE-Height is(a)-(d): (e) <br /> "If hi est existin ad"acent rade is below FFE-Hei ht is a + d <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> � Yes � No Permit Number: � Yes � No 0 0 Yes No <br /> /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 /> � Yes o 0 Yes No <br /> 1 2 3 4 5 _—. Type(s): Type(s): <br /> Updated: June 2017 <br /> z:\forms�plan review checklist 06-2017.docx <br />