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� � <br /> PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: � � ���� � Permit No.: �-�"` �`` Q ���/ <br /> �— <br /> Description of work: Date Rec'd: �/���! � <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: <br /> Building review by: ✓ Date Approved: � l <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: � Yes 0 No Date of Survey: Revised date(?): <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 heighY' �a� � <br /> definition : <br /> First Floor Elevation from buildin lans : (b) <br /> Highest Existing ground level (per survey)or 10' above lowest ground level, ��� <br /> whichever is lower: <br /> Difference befinreen b and c *: (d) <br /> DEFINED HEIGHT <br /> *If highest existing adjacent grade is above FFE-Height is(a)-(d): (e) <br /> *If hi hest existin ad'acent rade is be/ow FFE-Hei ht is a + d <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> O Yes � No Permit Number: 0 Yes � 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 /> � Yes 0 No 0 Yes 0 No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> , � <br /> Updated: June 2017 � <br /> z:\forms�plan review checklist 06-2017.docx <br /> i <br /> � . <br />