Laserfiche WebLink
Shorelanc� Di��rict R�C1AlD Perrnit ���ra�e Lak�shore Setback B�u� <br /> f�iet? <br /> Yss � No P�rmit I�umber: ;" �` �;; � Yes Q No E.� N/A � YE�o � <br /> �'' " <br /> � N/A—se2 attached Setback: <br /> Stormwater Qualit� Existing Proposed <br /> Qverla�y �is4rict�ier F�ardcQv�r 6�ardco�er �faciar�ce Rec�uired �U6� Req�ireci <br /> circle one % and sf % and sf <br /> �, Z3�p Qj p Yes � No � Yes o <br /> 1 � 2 �' 3 4 5 .�.�.-�� ype(s):� ; O�f�r� TYP��S)� <br /> �r <br /> �JG L C S-� � �', ����' ��"��' ° �� <br /> �f'� <br /> Fees to be Ghar ec! YE� t�Q <br /> Permit ��-�°``"; <br /> Plan Review I-�' <br /> State Surcharge i:�'' <br /> Investi�ation Fee ��`�� <br /> S�+►G�Numf�er of��G Unit� � <br /> Other(spe�ifyr) .��`� <br /> Square Foota e $ per S uare Foota e <br /> Basement ,�l�-.� ' X /�� •�.C� _ $ f����t J L � fl <br /> � 1 S' Floor � L�� �' X %��, � ' _ $ c,?� t�-'C� e�� <br /> � 2nd Floor /� � � X ��. � _ $ � �/�,�(� <br /> Garage /�t`�G�� X � ,�'' � _ $ �r 2,f�tl` <br /> Estir�atec€ Construction �/alue: �_� l `7'' � � _�`� _� �s '�� <br /> .�.�� <br /> �ror�o Inspec�ions RequirecE �ork F�ec�uiring Separate I�ermit� <br /> 4 w <br /> �Footing ❑ Site � Plumbing Q Grading/Filling <br /> q �Poured Wall �Silt Fence/Erosion Control � Mechanical � Fire <br /> ` � Foundation Survey Q Hardcover Removal � Fireplace �-1Nater Connection <br /> f ❑ Framing � Other(specify) � Masonry �� Sewer Connection <br /> t ��Waterproofing/Drain tile �Mfg. 0 Lawn Irrigation <br /> 1` �f�Foundation Wat�rproofing ❑ �Other(specify) � Landscaping <br /> }'� � Framing <br /> � Insulation <br /> � �As-Built Survey <br /> � �Final <br /> � Q Lathe f�eq�ired Stat� �ermi4g <br /> � Other(specify) <br /> � <br /> t � Well =� Electrical <br /> �����R�� (in-house): <br /> � OFFiCI�� l�E�i4R�C� ��"� �� ���'�� Ot� PERI�f��F�� iNPTEA�LE�: <br /> �e� �u6lc�er Ackno�ledgement ForrrE <br /> ��_.;�� <br /> Prior ase of escro -built survey and�a�F�l��#artivn�n'r�rs#�bmitted�n�t-�p�ea�d. <br /> Updated: May 2016 <br /> z:\forms\plan review checklist 5-2016.docx <br />