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f ' <br /> PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �lJ w ( L w J Permit No.: 201(o - �1` -0 <br /> Description of work: C- uof- MM_- Date Rec'd: 11 2-� ((o <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: l'�U' <br /> Building review by: Date Approved: 3 <br /> Grading review by: trtlh �� Date Approved: ' q. t 7 <br /> Zoning District: Re-15 Zoning File MIV -J Q.Y <br /> Resolution? Yes Reso M Reso Date: 0.10 4(119 Signed: Yes No Resolution I NA <br /> Zoning: Lot Area: t'01- SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: Yes 0 No Date of Survey: . ZZ' �� Revised date(?): <br /> Landscape plan submitted? 4 Yes Landscaper: IM I yl V1 0 t �'71�ef� 0 No/ None proposed <br /> Proposed Setbacks: \ ��2 ►`f 4. <br /> Front) Rear(S et) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Building Height Analysis: <br /> Distance Between First Floor and defined Top of <br /> Roof* See "buildingheight" definition): <br /> (a) <br /> First Floor Elevation (from building plans): (b) <br /> Highest Existing ground level (per survey) or 10' <br /> above lowest round level, whichever is lower: <br /> (c) a��i-(� <br /> Difference between b and (c): (d) } <br /> Defined Building Height (a) - (d): (e) <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Permit Number: _ (�� 0 Yes 0 No /dN/A 0 Yes <br /> 0 Yes 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 /> 1 2 3 4 <br /> �/p L 0 Yes No 0 Yes No <br /> p7Type(s): Type(s): <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />