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, , <br /> PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: z�5 lJ S, X'�� �, ,%� Permit No.: ���"���.� <br /> CL-� <br /> Description of work: Date Rec'd: <br /> Septic review by: Date Approved: <br /> Zoning review by: ,N Date Approved: <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? 0 Yes Landscaper: 0 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 defined Top of �a� � <br /> Roo�` See "buildin hei hY' definition : <br /> First Floor Elevation from buildin lans : (b) <br /> Highest Existing ground level (per survey) or 10' ��� <br /> above lowest round level, whichever is lower: <br /> Difference between b and c : (d) <br /> DEFINED HEIGHT If highest existing grade is: �e) <br /> above FFE-Height is(a)-(d) <br /> below FFE-Height is(a)+(d) <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Permit Number: � Yes � No � N/A 0 Yes 0 <br /> � Yes � No 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 0 No � 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 />