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, PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: J 7 � � S�`Q�L/r12 � �i��l/'li Permit No.: �d�S� �Dj,�� <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: 2 �Q <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: /AC Width: Structural Coverage: SF % <br /> Survey Submitted: � Yes � No Date of Survey: Revised date � : <br /> Landscape plan submitted? 0 Ye Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: <br /> Front(Lake) Rear(Street) ( S E W ) ( N E W ) Other Buildings Wetland <br /> Side Side <br /> Buildin Hei ht Anal sis: <br /> Distance Between First Floor and defined Top of Roo (See"building height" �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 abov FFE-Heigl�t is(a)-(d): (g) <br /> *If hi hest existin ad'acent rade is bel FFE-Hei hf is a + d <br /> Shoreland District WD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> � Yes � No Permit mber: � Yes 0 No � N/A � Yes 0 No <br /> 0 —see attached Setback: <br /> Stormwater Qual' Existing Proposed <br /> Overlay Distric ier Hardcover Hardcover Variance Required CUP Required <br /> circle on % and s % and s <br /> 0 Yes � No � Yes 0 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 />