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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: ( � . Permit No.: ��� I '' �,� <br /> Description of work: � Date Rec'd: _ �(!'�q ' �� <br /> Septic review by: ��-Q�/V � Wa 7�i' Date Approved: <br /> Zoning review by: Date Approved: 1 ' �d ' � <br /> Building review by: Date Approved: l <br /> Grading review by: �� ��w�= Date Approved: '(U��� <br /> . <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: �'S'es 0 No Date of Survey: � �Z7•�7 Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: <br /> Front(L e) Rear(St et) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> � <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and defined Top of <br /> Roof'` See "buildin hei ht" definition : �a� �q �� <br /> First Floor Elevation from buildin lans : (b) lu��� j <br /> Highest Existing ground level (per survey) or 10' ��� ��� ,'�, <br /> above lowest round level, whichever is lower: <br /> Difference between b and c : (d) �, J� <br /> DEFINED HEIGHT If highest existing grade is: �e� L , p- <br /> -above FFE-Height is(a)-(d) _ O <br /> below FFE-Height is(a)+(d) <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> / Permit Number: �'1 _ 3� � Yes � No �/A 0 Yes <br /> 0 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 No � Yes o <br /> 1 2 3 � 5 n(� nr� Type(s): Type(s): <br /> � �r � � <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />