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�.a : _ _,, . ._ _,__. , _,. .� _. �,r,a . �_ . .._ -_ <br /> _. _ .,_._., . . �. .s__ ,.._..,. , , <br /> �.� _ r.... „ .._......,_ <br /> �� <br /> �': , .. <br /> � Plan R�viev� Chec�clist for t�ew S�ructures / �4c�ditions <br /> � <br /> " Address/ PID/ Legai: �. �--�� '�� �L'������ (� � � �" <br /> Description of work ��`�..�'�� d���'�4���� <br /> Septic review by: �� Date Approved: ,/ '�?'� � �,�-� <br /> Zoning review by: � Date Approved: ��� B�i <br /> �, <br /> Building review by: -�� ►�• _ Date Approved: � '�- � -�::I <br /> Grading rediew b�: fr� Date Approvecl: � � !� <br /> Zoning File#: �� t�+ Resolution#: �� �4- Resolution Date: <br /> Zonin District Fi�e &�epartrr�ent Post Qffice School District <br /> �" f, n <br /> ��, @� $'`). <br /> Zoning: Lot Area �5����� 2,.D SF/AC Width: Depth: <br /> �F` Su►vey Submitted: .Q Yes � fVo Date of Surve : ''``�e "��� '"`�� <br /> y �.a .� � <br /> �` Pro osed Setbacks: <br /> y. � � <br /> '�,�roq�'(Lake) �e�a`(Streetj � N Side ��D ( N Side � w � Other Buildings Wetland <br /> .__�,`�: ;1`t ` ' ��� ' <br /> c �;� � � <br /> � , <br /> Building Defined Height: � • Building Peak Height: � #of Stories Ok?: YE <br /> � FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING O�t A SLAB FOUNDATION: <br /> STA H the distance between the basement floor/crawl START the distance between the sl 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 /> g,,,�� mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type <br /> or other arch-t e roof roof <br /> ��f SUBTRA� half the distance �the highest window and SUBTRACT half the distance between the highest window <br /> ' hi hest roof ea fa itched roof and hi hest roof eak of a itched roof <br /> SUBT AC the distance betvreen the basement floor/crawl ADD the distance between the slab and the highest <br /> � �3., space floor and the highest existing grade within existin rade within the foundation <br /> ��� the foundation or 10 fee .,w iche e�is less. EQUALS Defined buildin hei ht <br /> QUAL Defined builciin hei ht ;' � ,: <br /> �� � <br /> �� Lot Coverage: �� SF % <br /> �� Shoreland District MICWD Permit Received Avera e Lakeshore Setback Bluff <br /> �,�` es � No � N/A 0 Yes No <br /> 0 Yes Q'No 0 Yes 0 No ��A <br /> ° Permit Number. ���� � Setback: <br /> r <br /> ' Hardcover Zones Existin Pro osed Variance R ui ed ,C�' Required <br /> + �-75� � ❑ Yes �-No �Yes � No <br /> a <br /> 75-250' Type(s): Typ (s). ° - <br /> � 250-500' �- 'O�� <br /> � �- � � � <br /> t ; � <br /> �, 500-1000' � <br /> � REMARKS in-house : ���• �� � 6�� ���• � < � � �" <br /> � � � � � ��� � D <br /> ��, � <br /> � Updated: 09/11/2009 ' � ,/'�� � ������� <br /> �z z:\forms�plan review checklist.docx E'�f <br />