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P.LAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: Permit No.: ��7 � W �`f7 <br /> Description of work: �� Date Rec'd: +�'�7 '�� <br /> Septic review by: _ �/VV� �--- 1A� Date Approved: <br /> Zoning review by: Date Approved: c�' ��'�� <br /> ,�� �� i <br /> Building review by: ' � � Date Approved: � � <br /> Grading review by: V1l� Date Approved: 3 'O' �� <br /> Zoning District: Zoning File#: � �7 <br /> Resolution? Yes Reso#:��' Reso Date: ��'��•��Y Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: l /AC Width: (D�ir Structural Coverage: l �{ SF ���% <br /> Survey Submitted: `� Yes � No Date of Survey: Z• � '�, Revised date(?):�'�'f� <br /> '/\ �� 3 a.i7 <br /> �� � ; � � <br /> Landscape plan submitted? �Yes Landscaper: C�_�� �( ,,��i ,,.� - �- , 0 No/ None proposed <br /> �`' ti� � 'G ,'� ,!-� <br /> Pro osed Setbacks: ��� - ��� �Z��`� �'�� ���� <br /> � � �r <br /> Front( e Rear(St et)� ( � S E W ) ( N �S E W ) Other Buildings Wetland <br /> Side `3ide <br /> �5` 31' i � 1 ' � -- <br /> Buildina Heipht Analvsis: <br /> Distance Between First F�oor and defined Top of �a� � � <br /> Roof See "buildin hei ht" definition : <br /> First Floor Elevation from buildin lans : (b) ��,�' <br /> Highest Existing ground level (per survey) or 10' ��� �A� � <br /> above lowest round level, whichever is lower: `tv <br /> Difference between b and c : (d) �,�� <br /> Defined Buildin Hei ht (a -(d): �e� �p. ,l� <br /> ���'� ,'r'1 � <br /> Shoreland District MCWD Permit '- Av rage Lakeshore Setback g�uff <br /> Met? <br /> �Yes � No Permit Number: `�1 -� �7 Yes � No 0 N/A O Ye 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 /> ��� �l � b Z q, (� oG7 b Yes 0 No 0 Yes No <br /> � 2 3 4 5 ype(s): Type(s): <br /> l/ l�i �0 ` 31 � a S¢ <br /> LdE-d►zA�-� <br /> Updated: October 2016 �.�,C� <br /> v:\forms�plan review checklist 10-2016.docx <br /> � Slm�u�al Gotie�� <br />