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� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �7� �� L�rC.L�� 1pY • Permit No.: !�✓�� � V�5�.7 <br /> Description��o work; t �� �� Vl �'' Date Rec'd: �Z ' �'1 � <br /> Septic review by: �ZQ�'G 4-- Yva 1 � Date Approved: �"" <br /> Zoning review by: � Date Approved: 5 ' ��'�� <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 /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: 0 Yes 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 /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and defi p of �a� <br /> Roof See "buildin hei hY' defi � � n : <br /> First Floor Elevation from din lans : (b) <br /> Highest Existing gro d level (per survey) or 10' ��� ;;'� <br /> above lowest r nd level, whichever is lower: <br /> Difference tween b and c : (d) <br /> D ned Buildin Hei ht(a -(d): �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> 0 Yes O No Permit Number: � Yes 0 No N/A � 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 /> 0 Yes No 0 Yes No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />