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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: Tor)Q wa- Permit No.: 2-01 -00 W5 <br /> Description of work: 11111001 I 14 dM Date Recd: (o 'l J 4 7 <br /> Septic review by: UCLA �- Y��t I Date Approved: <br /> Zoning review by: I�CU�� Date Approved: - ' I <br /> Building review by: �w c. Date Approved: t! Z7 <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File#: <br /> Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution/N <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: es <br /> XN 0 Date of Survey: M" <br /> Revised date(?): <br /> Landscape plan submitted? 13 Yes Landscaper: 0 No/ None proposed <br /> Proposed Setbacks: <br /> /r(Street) <br /> a a <br /> Ft(Lake) Ror(Street)3 ( N S E 1� ( N S (F W�) Other Buildings Wetland <br /> Side Side <br /> 0 L <br /> Buildin4 Height Analysis: <br /> Distance Between First Floor and defined Top <br /> Roof* See "building height" definition): <br /> First Floor Elevation (from building plans): <br /> Highest Existing ground level (per survey) or 10' <br /> above lowest ground level, whichever is lower: <br /> Difference between b and (c): <br /> Defined Building Height (a) - (d): (e) <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Permit Number: Yes Cl No 13 N/A 0 Yes <br /> Yes 13 No No <br /> /A—see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and sf % and sf <br /> 0 Yes A5No E3 Yes Co <br /> r�1 2 3 4 5 VI 4 Type(s): Type(s). <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />