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�L��N RE�PiEW C�I�CKL1�� FOR lR�E1Elf STRUCI'Ul�ES / AQ�ITIOIVS <br /> Address/Permit Number: �� ��-�1�� ud► • <br /> Description of work: Vt+ltd��. 1 w�1 ��� � �i �.,�'L�.�.t I�0 <br /> Septic revievv by: - ��r Date Approvect: <br /> �'; Zoning review by: Date kpproved:_ � �/ � <br /> � Building review tay: Date Approved: � � t ' '�f � <br /> � Gradin rediew b ��� <br /> � g y: �ate Approded: <br /> ZonBng District: Zoning File#: Reso#: Reso Date: <br /> Zoning: Lot Area: SF /AC IE�idth: Lot CQverage: SF _% <br /> Survey SubmittecE: 0 Yes � No Date of Survey: Revised date(?): <br /> Pro osed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( f� S E 1M ) ��her Buiidin�s Mletland <br /> Side Side <br /> � Defined Height: Peak Height: FFE: FFE mirous 6 feet= (Existing Contour) <br /> � Perimeter(linear feet) = 50% _ #�f Storie� Ok? � YES <br /> �r: <br /> FOR A BUI�DING WITH A BASEMENT OR CRAWL SPACE: <br /> ` The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION: <br /> �,i. START WITH proposed floor(of the basement or crawl <br /> �' space)and the highest point of the roof. START WITH The distance between the top of slab and <br /> If you have a... <br /> the highest point of the roof. <br /> 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 /> 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 corresponding <br /> �' SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof <br /> �; (BASED ON ROOF . GABLE OR HIPPED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with <br /> TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half 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,etc:No subtraction. <br /> mansard,etc):No subtraction. ADDITION Add the distance between the top of slab <br /> SUBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to <br /> (BASED ON EXISTING basemenVcrawl 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 /> EQUALS Defined 6uilding height <br /> �;s<; <br /> Shorelanc€ [3istrict i�C1l�D �erm`f Receided �vera .e L�keshore �ett�ack I��t� �f�eff <br /> � Yes � No � N/A � Yes � No <br /> � Yes C7 No � Yes � No 0 N/A <br /> Permit Number: Setback: <br /> Sformwater Quafity Existing �roposed �ariance I�equirec� CEJ� P��c�uiree� <br /> Overla District�ier F{aecEcover �Eac��over <br /> � Yes �E No � Yes E� No <br /> Type(s): Ti ype(s): <br /> Updated: January 2013 <br /> v:\forms\plan review checklist 2013.docx <br />