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�;,1<< , < <, r ,� .:,.-�, _�,T _ _.., _.r ._... .�.. _�.. - � <br /> :' , � l��a� �e���� G�eckl�s� for A��v� Struct��es / �4��i�i�n� <br /> r Address/ PID/ Legal: � �! �����T -���� � � ��� <br /> � <br /> � <br /> Description of work: <br /> � �'� . <br /> Septic review by: � � Date Approved:_�� `' ✓ ��� <br /> e ,- � <br /> Zoning review by: Date Approved: �[ � � � � <br /> �' Building review by: �� ����rj�� �f•�--- Date Approved: � � � � - ` { <br /> , <br /> Grading review by: ��`��'� r� �' r ` w'� Date Approved: p�������-��� � <br /> � � <br /> Zoning File#: Resolution#: Resolution Date: <br /> Zoning District Fire Department Post Office �chool Qistcict <br /> ���'�� <br /> Zoning: Lot Area: �� . �� SF AC Width: Depth: <br /> '� �_ <br /> Survey Submitted: ,� � No Date of Survey: � ��" � T � <br /> Proposed Setbacks: <br /> •.m� „��--- <br /> Fron (La ek Rear�� �� ( N�S"' E W ) (�� S E W ) Other Buildings VNetland <br /> �' Side Side <br /> �C y�r �t���- `�°� � -��� �.;� �� <br /> t3r. <br /> Building Defined Height: Building Peak Height: #of Stories Ok?: � YES <br /> FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: <br /> START WITH the distance between the basement floor/crawl START the distance between the slab and the highest <br /> space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, <br /> the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the <br /> mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type <br /> or other arch-t e roof roof <br /> SUBTRACT half the distance between the highest window and SUBTRACT half the distance bet�reen the highest window <br /> hi hest roof eak of a itched roof and hi hest roof eak of a itched roof <br /> SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest <br /> � space floor and the highest existing grade within existin rade within the foundation <br /> the foundation or 10 feet, whichever is less. EQUALS Defined buildin hei ht <br /> EQUALS Defined buildin hei ht <br /> Lot Coverage: SF % <br /> Share[and District IV{CW� Perrr�it F�eceived Avera e Lakeshore Setb�ck Bluff <br /> �� ,� 0 Yes � No 0 N/A � Yes ,,.,.L�No <br /> r ,�J Yes ❑ No � Yes ❑ No ❑ N/A <br /> � Permit Number. (���� ��E.�;�� Setback: <br /> , <br /> Hardcover Zones Existin Rro osed Variance Requir CUP Required <br /> 0-75' ��;: �� ❑ Yes � No [� Yes r=��frio <br /> 75-250' "�����' ��`t�� Type�s�� TYPe(S)- <br /> 250-500' ���`����;� (���� <br /> 500-1000' <br /> r <br /> REMARKS (in-house�: � : yt�'�,� ' �� , ��c�� � � �� <br /> ����-� , �' <br /> "' Updated: 09/11/2009 `� <br /> ��` z:\forms�plan review checklist.docx <br /> + <br /> �'; <br />