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Plan Review Checklist <br /> 1,- - (\e,hecklist for New Structures / Additions <br /> Address/ PID/ Legal: 2-01 �1,- - (\e, �� <br /> ( (AIL' <br /> L' <br /> Description of work: 00--- 4WY Ylw' t \ n— K-( 14) <br /> Septic review by: A :$,-(Avci Date Approved: S- 1 0 '( 2— <br /> Zoning review by: C) Date Approved: - 25--1 2._ <br /> Building review by: 4) Date Approved: 5- Z5-- -i- <br /> ____ z S -l- <br /> Grading review by: Date Approved: <br /> Zoning File#: N A- Resolution#: Nk Resolution Date: <br /> Zoning District Fire Department Post Office School District <br /> 1---Ic.- <br /> Zoning: Lot Area: SF/AC Width: Depth: <br /> Survey Submitted: ❑ YesO Date of Survey: <br /> • <br /> Proposed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> Building Defined Height: Building Peak Height: #of Stories Ok?: ❑ YES <br /> FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: <br /> START WITH the distance between the basement floor/crawl START the distance between the slab and the highest <br /> space floor and the highest roof peak, the top of WITH roof peak,the top of the cornice of a flat roof, <br /> the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the <br /> mansard roof,or the uppermost point on a round uppermost point on a round or other arch-type <br /> or other arch-type roof roof <br /> SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window <br /> highest roof peak of a pitched roof and highest roof peak of a pitched roof <br /> SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest <br /> space floor and the highest existing grade within existing grade within the foundation <br /> the foundation or 10 feet,whichever is less. EQUALS Defined building height <br /> EQUALS Defined building height <br /> Lot Coverage: SF <br /> Shoreland District MCWD Permit Received Average Lakeshore Setback Bluff <br /> YYe ❑ <br /> ❑ Yes 1:1 No ❑ N/A / ❑ Yes No <br /> s 0 No Yes 0 No ./p'N/A <br /> Permit Number: Setback: <br /> Hardcover Zones Existing Proposed Variance Require CUP Required <br /> 0-75' 0 Yes / No 0 Yes o <br /> 75-250' Type(s): Type(s): <br /> 250-500' <br /> 500-1000' <br /> REMARKS (in-house): Dec,e t,✓A,5 A pd.-cued 6? vAn.(.4-r/c.a 47'lo2 c.J �c,c( / !72 <br /> NA/4.406c_ 1,0A-5 �IL A 3 ' aA-� c <br /> c4. - 6-c cc. L ..,4s ,gJ , ( v�[T- Z ' <br /> Updated: 09/11/2009 r/- -- & r- L.,( n '- �1.: y (4 c.-,P p/1-.on.7C- /I/w3 9- /Y`A.1-4' 3 i 5_,2.4-1340 <br /> z:\forms\plan review checklist.docx <br />