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. <br /> • � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: ( l l3s� , �,0(iL��5 �`i'1/`� Permit No.: <br /> Description of work: Date Rec'd: <br /> , <br /> Septic review by: Gf/ e� Date Approved: <br /> Zoning review by: Date Approved: <br /> Building review by: Date Approved:_ Z <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: es No Resolution/NA <br /> Zoning: Lot Area: SF/ C Width: Stru ral Coverage: SF % <br /> Survey Submitted: � Yes No Date of Survey: Revised date ? : <br /> Landscape plan submitted? � Yes andscaper: � No/None proposed <br /> Pro osed Setbacks: <br /> Front(Lake) Rear(Street) ( S E W ) ( S E W ) Other Buildings Wetland <br /> Side Side <br /> Buildin Hei ht Anal sis: <br /> Distance Between First Floor and defined p of Ro f*(See"building heighY' �a� � <br /> definition : <br /> First Floor Elevation from buildin lans : (b) <br /> Highest Existing ground level (per survey) or 1 ' above lowest ground level, ��� <br /> whichever is lower: <br /> Difference between b and c *: (d) <br /> DEFINED HEIGHT <br /> *!f highest existing adjacent grade is above FE-Height i (a)-(d): (e) <br /> *If hi hest existin ad'acent rade is below FE-Hei ht is a + d <br /> Shoreland District MCW Permit Average Lakeshore Setback gluff <br /> Met? <br /> 0 Yes � No Permit Number� 0 Yes � No 0 N/A � Yes � No <br /> � N/A—see ttached Setback: <br /> Stormwater Quality xisting Propose <br /> Overlay District Tier ardcover Hardcove Variance Required CUP Required <br /> circle one % 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 />