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�l�n ��vi�� �h�c�1E��t for;�e� :�t�-uc��r�s / �►dt�iti�r�� <br /> : �� � � � �� � � <br /> Address/PID /LegaL ,� <br /> Descriptinn of work: � ���k�.�%�� � ���i � ��� �'' <br /> }� <br /> - S�.ptic re�riewhy: _ � � �� Date i4pprovec3: �� � ��`` � <br /> Zoning review,by: , Date ARproved: ��'.-� �'� <br /> �uilding�re�iew bY: _ �Ba�e Ap�cove�: ����� <br /> �+ Grading veview by: • ' Date ApprQvecl: <br /> �. <br /> Zonin File#: a� �" . ,��� �(,r ; :��— _ <br /> 9 � REsalu�i�on#. �, -,��,� � ��esolution'�D�te: `� � �'� .,� � , , <br /> Zoning�L3ist.rict Fire D:epartment �ost O�ce Sc ool D'estriat <br /> � <br /> Zoning: Lo# rea: SF/AC VUidth: Depth: <br /> Survey Su�mitted: �Yes ❑ t�o Qate�fSurvey:_��� �� � <br /> '�: Pro osetl Setbacks: <br /> � „Front.(Lake) Rear�Str�etj { tV S :E 1M � ( N :S E IIV j ther.�uilciin s `V11�etland <br /> �.-: : <br /> �ade �i�e. �°� ' ��� ��'. <br /> r�: , � <br /> I <br /> t� k � � r <br /> Building Defined'Height: ���" � �� Suilding Pea�C Height: " � � #of Stories Ok?: _ . YE5 <br /> FOR.A.BUILDIN.G,WIThl:A�BA�EMENT OR`C'RAWL SPACE: FOR'�"Bti1LDIAIG�ON A SLAB FOUNdAT10N: <br /> STAfZT WITH the distance beiween'the basement floor/crawl STARI" the distanee between the slab and the highest <br /> � space:floor and the highest roof peak;the,top of WITH roof peak,the top of the:comice ofi a flat roof, <br /> �g�g� ; ' #hs cocnice af a flat ro�f,the.,deck Ime of a the deck line of a mansacd roof, or the, , <br /> `�� �� � �' mansard roof,or the uppermost�pomt�on a round ' u <br /> ppermost point on a round or,other arch-type <br /> nr other arch-t e roof roof <br /> SUB , � ,� half Yhe distance between the highest window and SI�BTRACT hatf the dis.tanee between the highest-window <br /> �, (� �j � d� hi hest roof eak of a itched r and hi hest roof eak of.:a itched cDof <br /> ���fi SUSTRAC the distance between the bas ` n ,fl�r/crawl ADD the:distance between>the slab and#he highest <br /> space floor and the highest e" i '�r ,�within existin rade within the foundafion' <br /> the foundafion or 10 feet,which ve'.iskiess: EQUALS Defined buildin hei hf <br /> EQUALS Defined buildin hei ht <br /> Lot Coverage: SF o/p - <br /> x <br /> Shorefa�d District �lND Rermit Receiv.eci �v ra e'Lakeshore S:etback Biu <br /> � �es � No ❑ N/A '. � Yes No <br /> �'Qs ❑ N° s� 0 No : /A <br /> d Pecmit Number. ���� Setback: <br /> Hardco�aerZones Existin Pr��osed ,�l�iar�ce i�e uired CUP Re t�6r tl <br /> 0-75' ,� ;. :� � ��• � Y-ss Q No ❑ Yes No <br /> 75-250' � �''� � 6°�` ;� T�P �5�� ����� TYPe�S)• <br /> � 250-50D' � '� <br /> � ��� <br /> �D0-1000' <br /> REMARKS jin-house): <br /> Updated: Q9/11/20d9 <br /> z:lformslpian review checklist.docx <br />