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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: U 7 % I / [f� ,a'1/I l (>iE!/ �'(— Permit No.: 74 t?`(9 06U <br /> Description of work: gjdz- klyl (/' !/ � Date Recd: <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: <br /> Building review by: Date Approved: <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File M <br /> Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: 0 Yes 0 No Date of Sur�y: Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: / 0 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 /> Buildina Hei ht Analysis: <br /> Distance Between First Floor and defined Top of Roof*(See"building height" (a) <br /> definition): <br /> First Floor Elevation from building plans):/ (b) <br /> Highest Existing ground level (per survey)or 10'above lowest ground level, (c) <br /> whichever is lower: <br /> Difference between b and (c)*: (d) <br /> DEFINED HEIGHT <br /> *If highest existing adjacent grade is bove FFE-Height is(a)-(d): (e) <br /> *If highest existingadjacent rade i below FFE-Height is a + d <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> 0 Yes 0 No Permit Number: 0 Yes 0 No 0 N/A 0 Yes 0 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 % ands % and s <br /> 0 Yes 0 No 0 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 />