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� , PLA[V REVlEW CHECF(LIST FOR {`lEW STRUCTURES / A�DITIOI�S <br /> Address/Permit Number: �o� �`���� l'�F � E�„� <br /> Qescription of r�rork: �� ` <br /> � Se tic revieHr b Qate A �� <br /> �, p Y� pprQved: <br /> Zoning review by: ""� Date Approved: ��'�' � <br /> Building review by: Date Approved: l�` � ° d� <br /> Grading review by: Date Appravecl: �°�' �� <br /> Zaning District: Zoning File#: Reso#: I�eso Qate: <br /> Zoning: Lot Area: SF/AC 1!1lidth: Lot Coverage: SF _% <br /> Survey Submitted: � Yes - No Date of Survey: Revised date(?): <br /> Rro osed Setbacks: <br /> Front(Lake) Rear(�treet) ( N S E W ) ( N S E 1�11 ) Qther�u6lding,s �1►�tland <br /> Side Sicie <br /> Definec6 F�eight: Peak Height: FFE: FFE minus 6 fe�t= (Existing Contour) <br /> Perimeter(linear feet) = 50%_ #of Stories Ok? � YES <br /> �_ <br /> FOR A BUILDING WITH A BASENiENT OR CRAWL SPACE: <br /> The distance between the lowest FOR A BUILDIPEG ON A SLAB FOUNDATION: <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 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 <br /> SUBTRACTION corresponding gable or hipped roof to the 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. <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 building height <br /> f'- <br /> ! <br /> ,r <br /> ' . Shoreland �istrict MGWD Permit Receivec9 Avera e Lakeshore �etb�ck IVlet? Bluff <br /> '° � Yes � No 0 N/A � Yes No <br /> �Yes � No �es � No 0 N/A <br /> Permit Number. E�^� �� Setback: <br /> - Stormwater Quality Existinc� Proposed Variance Required CElP RequirecE <br /> Overla �istrict Tier Hardcaver Hardcover <br /> Yes � No a Yes No <br /> TYpe(S)��`�.3 TYPe(S)� <br /> Updated: January 2013 <br /> v:\forms�plan review checklist 2013.docx <br />