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�� � <br /> " ���.�►� ���'{EVII �H���LIST FOR ����S�R�C�@Ji�ES / �►�DiTIO1�S <br /> � AdaresslPermit Number: ���� ��/� ����� ��N�= <br /> Description of work: N�� �� <br /> � Date A roved: �— <br /> �,; Septic rediew by: pp <br /> Zoning redievu�b�+: � Date Approded: �' ��' I <br /> Building review by: � Date ApprQ�+ed: S–�.l- � <br /> Grading review by: ��/ Date Approved: �a. <� <br /> �oning District: Zoning File#: Reso#: Reso Date: <br /> � � <br /> �oning: Lot�,rea: ����f FS�'/AC Width: P�ot Coverage: �.�C�� �SF I��o <br /> - a � ��, <br /> Sunrey Submitted: �s � No Date of Surve�+: �,"` i,� Revised date(?):� F-s� ! <br /> �^ E �� � ���_,. <br /> Pro osec! Setbacks: <br /> Front(Lake) F�zie(Street) 1 � S � � ) ( � S E � � Other Builctir�gs Wetland <br /> � Sid� Side <br /> �� �' <br /> �G'.( �ir� - � "!�' P`i'F;�• <br /> t ,� �. �' �;c':.Y; .. I c� � @ u � �� � <br /> Defineci Height: Peak Fieight: FFE:�'�.� �'r�1�` F�E minus 6 feet= �G �"�`�� ;� (Existing Contour) <br /> , � i <br /> Perimeter(linear feet) _ �1�1 '�� 30'%0` ' #of Stories �Ok? Q YES <br /> FOR A BUILDING WITH A BASENiEI�T OR CRAWL SPACE: <br /> � F The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION: <br /> , START WITH proposed floor(of the basement or crawl <br /> :� ;i� space)and the highest point of the roof. START WITH The distance belween the top of slab and <br /> the highest point of the roof. <br /> If you have a... <br /> If you have a... <br /> � GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no <br /> ',y-s 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 poi�t 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 e GABLE OR HIPPED ROOF(with (BASED ON . GABIE OR HIPPED ROOF(with <br /> �'PE) 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. mansard,etc:No subtraction. <br /> ADDITION Add the distance between the top of slab <br /> �� � SUBTR,4CTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to <br /> ���`� ' „ (BASED ON EXISTING basemenUcrawl 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 bui�ding height <br /> �� EQUALS Defined building height <br /> �, <br /> Shorelancd District MC1l�f� �ermit Receive� �►�era e l�akeshore S�tback �et? Bluf� <br /> Yes � No 0 N/P, � CE Yes t� f�o <br /> �s � No ��' �� ' � Yes � No � I�/A <br /> � Permit Number: Setback: <br /> �` Stormwater Quafit: E�casti�c Pro osec! <br /> �. � � P ���e�nce ��quired ,- CIIF� Requirec� <br /> �verla District Tier �fardc�ver �iarc�cov�r ; <br /> � .� � :'-✓ �� �� �1:�: � Ye� ��`� P!o C� Yes E�'`No <br /> t� �� � <br /> � , ��. ��:, Type(s): Type(s): � V <br /> , '.< ,; � f l�� <br /> Updated: January 2013 <br /> v:\forms�plan review checklist 2013.docx <br />