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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: C "l5 W '5 Thu �d1 ; Perm it No. : 17— 02w <br /> ka;Description of work: Nem TQ CJ' Date Rec'd: 3 •z7'/ <br /> Septic review by: Save/ '—We,l I Date Approved: <br /> Zoning review by: Cr ISL Date Approved: 4''24'1 7 <br /> Building review by: ROIL/ W Date Approved: 4[_4-•17 <br /> Grading review by: — Date Approved: <br /> Zoning District: (..4—I5 Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution, <br /> 110 <br /> I 05 Noo eras <br /> Zon5ing: Lot Area: r ego /AC Width: Structural Coverage: IDIj SF 11.4 <br /> _Su verSubmitted: es D No Date of Survey: NA, Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: D None proposed <br /> Proposed Setbacks: <br /> �g T <br /> to <br /> Fr t(Lake) Rr(Street) ( N S E W ( N S E W ) Other Buildings Wetland <br /> Si Side <br /> dor 50' H ' --' <br /> Building Height Analysis: <br /> Distance Between First Floor anVe<d Top of (a) <br /> L--;j ' <br /> Roof* (See "building height" dpfmition): <br /> First Floor Elevation (fr nrbuilding plans): (b) <br /> Highest Existing gr nd level (per survey) or 10' (c) 7. <br /> above lowest and level, whichever is lower: <br /> Different etween (b) and (c): (d) <br /> fined Building Height (a) -(d): <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> 0 Yes )17 <br /> Permit Number: AYes 0 No 0 N/A <br /> /Yes D No 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 sf) (% and sf) _ <br /> ? (p, 4.3 0 Yesto 0 Yes <br /> dirp/ 2 3 4 5 21.1.�m„� Type(s): f Type(s): <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />