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, PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: Permit No.: �� I � Q�� <br /> Description of work: t'�1Y�lah�T' wa�� � �/{y 1 Date Rec'd: �''�' �� <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: '��i+ �� [ <br /> Building review by: Date Approved: �� 24� / <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/ NA <br /> Zon ng: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> S��tSutimitted: � Yes � No Date of Surve : Revised date ? : <br /> -�9 Y ( ) <br /> Landscape plan submitted? � 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 /> f . <br /> Highest Existing ground level (per survey) above lowest ground level, ��� <br /> whichever is lower: ,,, <br /> Difference between b and � � (d) �' <br /> : <br /> DEFINED HEIG T� � <br /> "If highest ex' : g adjacent grade is above FFE-Height is(a)-(d): ( <br /> "If hi hes xist►n ad'acent rade is be/ow FFE-Hei ht is a + d � <br /> Shoreland District MCWD Permit Average Lakeshore Setback B� <br /> Met? <br /> � Yes � No Permit Number 0 Yes o 0 N/A es � No <br /> � N/ ee attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Require " CUP Required <br /> circle one % and s % and s <br /> � Yes 0 No � Yes � No <br /> 1 2 3 4 5 ype . Type(s): <br /> Updated: June 2017 <br /> z:\forms�plan review checklist 06-2017.docx <br />