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[ <br /> PL�►[� RE���1�11f �EiE�6�LIST FOR �E1lV ��RtlCl'U��S / �►�QIl'i0�� <br /> � � r- ��,�� � <br /> Addr�sslPermit tVur�ber: �� � � ` �� � (�f� <br /> � <br /> �` Efescription of vvork: ��� � <br /> �' <br /> Septic review by: _ ;`��� Date Approveci: <br /> Zonin� reviewr by: �S Date�,pprovecl: �D'��• ��' <br /> �uilclir�g revievv by: �•..-��— Date Approved: �'�� � � ' <br /> Grading revievv by: �<�� Date�pproved: S o ) <br /> �. <br /> �� �oning District: �oning File#: �'�,�� F�eso#�: � �� F�eso �ate:��� <br /> Zoning: Lot Area: SF/AC 1lWidth: Lo4�Qvera��: SF _% <br /> Sunrey Submittec�: 0 Yes �No Date of Su ey: �'�• ��' Revised date(?): <br /> Pro �sed Seti�ac�zs: �(�{� ���{ <br /> F t(Lake) Rear(Street) ( �' �S E W ) ( N S E W ) Other Buildinc,�s lhaetland <br /> ! <br /> � `�id� Side <br /> .�-�— � `� <br /> �efic�ed Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contou�} <br /> Perimeter(linear feet) = 5Q%_ #of Stories Ok? 0 YES <br /> FOR A BUILDING YVITH A BASENfEt�T OR CRA41(L SPACE: <br /> The distance between the lowest �OR A BUILDING ON A SLAB FOUNDRTIOR": <br /> 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 /> the highest point of the roof. <br /> If you have a... If you have a.. <br /> • GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no <br /> windows): Subtract half the window Subtract half the distance <br /> s ance between the highest point be n the highest point of the roof <br /> of the roof to the low point of the <br /> SUBTRACTION corcesponding gable or hipped roof he low point of the corresponding <br /> 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. ` / mansard,etc:No subtraction. <br /> :�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 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 building height <br /> EQUALS Defined building height <br /> Shorefand I�istrict Fi�C1Cd� �ermet Receivec➢ �vera e Lake�hore Set��c{� N`ie�? Bfuff <br /> L� Yes � fVo C] N/A � Yes � P�o <br /> �Yes 0 No � Yes �No t�/� <br /> Permit Number: � �� Setback: <br /> � <br /> Stormwater Qualift�r Existin� Froposec� ��riance Requirect CU� Rec�uirecf <br /> Q�erla Dist�ict Tier [�ardcover Ffard��ver <br /> �E� S ���' Yes CF No � Yes No <br /> � �2..��� �1•��� T ��' : Type(s): <br /> Updated: January 2013 <br /> v:\forms�plan review checklist 2013.docx <br /> �:,. <br />