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�LAR� I�E�✓IEV1/ CH�Cl4LIST �OR NE1N STRUCTU�ES / 14DDITIOI�S <br /> Address: � � �� � �� Permit No.: ���� <br /> Description of work: EJ`-- �� Date Rec'd: � m�-�' " <br /> �'" Septic review by: .�[JNV Vlr Date Approved: �= <br /> � Zoning review by: Date Approved: <br /> Building review by: Date Approved: 2 "� - � ��/ <br /> Grading review by: Date Approved: <br /> Zoning District: ��Q Zoning Fi1e#: Reso#: Reso Date: <br /> ,�_� <br /> Zoning: Lot Area: S /AC•� Vlliclth: Lot Coverage J r-.�:"� ��'_.`.�;, , SF E. :�t % <br /> Survey Submitted: . Yes � No Date of Survey: I' � ' �� Revised date(?): <br /> ; Proposed Setbacks: <br /> Front(�e� Rear(S et) �� S E 11� ( IV E V11 ) �� Wetland <br /> Side ��ide � <br /> � �` `�� �` � ( ��� <br /> Defined Height: Peak Height: FFE: - FFE minus 6 fieet= (Existing Contour <br /> Perimeter(linear feet) _ �- - 50% _ �E-�- � , L.F. below grade #of Stories .- <br /> FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: <br /> The distance between the lowest proposed The distance between the top of <br /> START WITH floor(of the basement or crawl space)and START WITH slab and the highest point of the <br /> , the highest point of the roof. roof. <br /> If you have a... If you have a... <br /> • GABLE OR HIPPED ROOF <br /> • GABLE OR HIPPED ROOF(no (no windows): Subtract haii <br /> - windows): Subtract half the distance <br /> between the highest point of the roof the distance between the <br /> ���- , highest point of the roof to <br /> � — to the low point of the corresponding <br /> able or hi e the low point of the <br /> Y � . SUBTRACTION 9 pp d roof corresponding gable or <br /> (BASED ON . GABLE OR HIPPED ROOF(with SUBTRACTION hipped roof <br /> ROOF TYPE) windows): Subtract half the distance (BASED ON . GABLE OR HIPPED ROOF <br /> � `"� between the top of the highest ROOF TYPE) (with windows): Subtract <br /> window and the highest point of the half the distance between <br /> roof the top of the highest <br /> • ALL OTHER ROOF TYPES(flat, window and the highest <br /> mansard,etc):No subtraction. point of the roof <br /> • ALL OTHER ROOF TYPES <br /> SUBTRACTION Subtract the distance between the (flat,mansard,etc):No <br /> (BASED ON basemenUcrawl space floor and the subtraction. <br /> �� `" ' EXISTING hi hest existin rade ad'acent to the <br /> �,` 9 9 9 1 ADDITION Add the distance between the top <br /> _ � GRADES) foundation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing <br /> �t°-�'� - EQUALS Defined building height EXISTING grade adjacent to the foundation. <br /> rr � ._' � �_� GRADES <br /> ��"�41 � � ` '"� EQUALS Defined building height <br /> Shoreland District A4CWD Permit �verage Lakeshore Setback gluff <br /> Mlet? <br /> �Yes 0 No Permit Number. ��— Q Yes � No N/A ❑ Yes No <br /> ' � N/A—see attached Setback: <br /> Stormwater Quality Existing Hardcover Proposed <br /> Overlay District o Hardcover Variance Required CUP Required <br /> Tier circle one) (�o and s� % and s <br /> �@ ����, � � Yes � No � Yes � No <br /> 1 ( "L� 3 4 5 �-�" ���� Type(s): Type(s): <br /> �� <br /> Updated: January 2015 <br /> z:\forms\plan review checklist 2015.docx <br />