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r PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: Z-Z Lj -7--A2^ �cf "-e— Permit No.: Z0/7-- 005/0 <br /> Description of work: Date Rec'd: <br /> Septic review by: Date Approved: <br /> Zoning review by. Date Approved: <br /> Building review by: Date Approved: -Z/7//7 <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File M J <br /> Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution/Ni <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: ❑ Yes ❑ No Date of Survey: Revised date(?): <br /> Landscape plan submitted? ❑ Yes Landscaper: ❑ No/ None proposed <br /> Proposed Setbacks: <br /> Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Buildinq Height Analysis: <br /> DistanceBet een First Floor and defined To of (a) <br /> Roof* See b ildin height" definition): <br /> First Floor Elev tion (from building plans / (b) <br /> Highest Existing round level (per sure y) or 10' (c) <br /> above lowest ro nd level, whicheve is lower: <br /> Difference betwee b and (c): (d) <br /> DEFINED HEIGHT If hi hest existing gr de is: (e) <br /> above FFE-Height is(a)-(d) <br /> below FFE-Height is(a) (d) <br /> Shoreland District MCWDer t Average Lakeshore Setback Bluff <br /> Met? <br /> Permit Number: ❑ Yes ❑ No ❑ N/A ❑ Yes ❑ <br /> ❑ Yes ❑ No V No <br /> ❑ N/A—see attache Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcov r Hardcover Variance Required CUP Required <br /> circle one % and % and s <br /> ❑ Yes ❑ 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 />