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f <br /> �Pf�A1V REVIEVN CE�ECKLISI` FOR �ilEV11 STRUCTURES / �D�IT�O�JS <br /> Address/Permit Number: �� �I`, C SC--C� O(N r � <br /> ?�/ 6Yd �C�S h���� DYZ <br /> Description of work: � i��'�-��� <br /> Septic revievv by: /�(� �ate�►pproded: <br /> Zoning reviewr by: Y V`� Date Approved: � — �� �(� <br /> Building review by: Date Approved: `�- Z Z -��o� <br /> Grading review by: 6�>� `�c� V`�� Date Appeoved:_ 5 —� �� <br /> Zoning District: �Fs�� Zoning File#: Reso#: Reso Date: <br /> Zaning: Lot Area: �,i�� S /AC 1A�idth: Lot Coverage: ,5� ( SF � /o <br /> Survey Submitted: � Yes �No Date of Survey: �'���" � �j Revised date(�)� 4'�"� <br /> Wro osed Setbacks: <br /> Front(L� Rear(Str t) S E W ) ( N S E W ) Other Bukldings 1lVetland <br /> / Side de <br /> f�•�, � <br /> t , <br /> Defined Height: �� ' P�ak Height: �� � FFE: FFE minus 6 feet= (Existincy Contour) <br /> �`t <br /> Perimeter(linear feet) = 50% _ #of S�ories Ok?� \YES <br /> � FOR A BUILDING liVITH A BASEMENT OR CRAWL SPACE: <br /> The distance between the lowest �OR A�UILDING ON A SLAB FOUNDATION: <br /> �_ �_ START WITH proposed floor(of the basement or crawl <br /> 1= — � space)and the highest point of the roof. START WITH The distance between the top of slab and <br /> the highest point of the roof. <br /> If you have a... If you have a... <br /> • GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no <br /> windows): Subtract half the windows): Subtract half the distance <br /> f distance between the highest point between the highest point of the roof <br /> of the roof to the low point of the to the low point of the correspor�ding <br /> a SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof <br /> !�— j,� � (BASED ON ROOF . GABLE OR HIPPED ROOF(with (BASED ON e GABLE OR HIPPED ROOF(with <br /> � ` TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract ha�f the distance <br /> distance between the top of the between the top of the highest <br /> highest window and the highest window and the highest point of the <br /> point of the roof roof <br /> • ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat, <br /> mansard,e4c:No subtraction. <br /> mansard,etc):No subtraction. ADDITION Add the distance between the top of slab <br /> ' Subtract the distance between the (BASED ON and the highest existing grade adjacent to <br /> � SUBTRACTION �=+, <br /> � � i;f� (BASED ON EXISTING basement/crawl space floor and the EXISTING the foundation. <br /> _/' GRADES) highest existing grade adjacent to the GRADES <br /> foundation OR 10 feet(whichever is less)_ EQUALS Defined building height <br /> � EQLlALS Defined building height <br /> (J�x�,�'� <br /> t - <br /> �horeiane� �istrict NICWD �er it Receiv �vera e �akeshore Setback Niet? Bluff <br /> � Yes No N/A � Yes No <br /> ��Yes � No � �t�` � Yes ❑ No �/A <br /> Permit Number: .��� Setback: <br /> � <br /> �toemwater Quality Exi�ting l�ropQsed �ariance i�ec�uiresl CUP Required <br /> Overla District Tier Fiardcover F�a,rcicover <br /> � Yes No � Yes t�o <br /> � �a� TYPe(S)� �Yp�(s)� <br /> �', <br /> � Updated: January 2013 <br /> � v:\forms\plan review checklist 2013.docx <br /> �. � , <br />