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, . PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: � L� J���� �• Permit No.: �-tJ�7 � �73� <br /> Description of work: �I�Y���,/'' TGIN1��_,,, Date Rec'd: � '�-1 ' � 7 <br /> Septic review by: ���Q�/1/V Y- W Q 1"W Date Approved: <br /> Zoning review by: Date Approved: � ' � i '�� <br /> Building review by: Date Approved: � l <br /> Grading review by: �m �h�A!H/J Date Approved: • (c� '� <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: �es 0 No Date of Survey: �D'Z?' � l Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: `C] No/None proposed, <br /> Pro osed Setbacks: <br /> Front(L e) Rear( eet) (� S E W ) ( N '� E W ) Other Buildings Wetland <br /> Side ` -�ide <br /> -� � � � � � � - �, <br /> Buildinca Heiqht Analvsis: <br /> Distance Between First Floor and defined Top of �a� � � . <br /> � Roof See "buildin hei hY' definition : <br /> � <br /> � First Floor Elevation from buildin lans : (b) <br /> � \Q 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-F�-€--�leight-+s+aj-(�) . <br /> below FFE-Height is(a)+(d) <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> 0 Yes �o Permit Number: (,�—3� 0 Yes 0 No �q � Yes <br /> No <br /> 0 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 /> 1 2 3 4� 5 � � � 0 Yes No � Yes No <br /> l.J 1� � TYPe(S)� Type(s): <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />