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�LI�(� ��\P�EI�V �FiEG�LE��' �'Q�. �E� �T�P�CT���S / ���ITfQt�S <br /> Ac�dress/Permit Number: D�� ����i rt f � ��J <br /> Descriptior� of work: ���1�'1�-- �� � ���-- <br /> Septic review+ by: �— �°J�ll(�`�l� �ate Appro�ed: �—' <br /> Zoning reviev�r b�: _ Date�►pproved: � ' � • ��I� <br /> Building review by: �ate �,pproved: � ��� ^- '�c °�' <br /> Grading reviewr by: E� � �ate Approved: <br /> Zoning District: Zonir�g Fil�#: r ' � Reso#�: Reso Dat�: <br /> Zoning: Lot Are�: SF/AC �idth: L�t C�verage �-�'�� �� � � -- SF. _% <br /> � <br /> Survey Submitted: Yes � No Date of Survey: ��� � I`f Revised date(?): <br /> Proposed Setbacks: <br /> Front(Lake) Rear(�treet) � � S E W ) ( N S E 1!� ) Other Builciin�s l�etland <br /> Sid� Side <br /> Defined Height: Peak Height: FFE: FFE minu� 6 feet= (Existing Contour) <br /> Perimeter(linear feet) = 50% _ #of Stories Ok? 0 YES <br /> FOR A BUILDING WITH A BASEIViENT OR CRAIML SPACE: <br /> The distance betv✓een the lowest FOR R BUILDING OPI A SLAB FOUND<lTIQt�: <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 /> If you have a... the highest point ofthe roof. <br /> {' 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 to the low point of the corresponding <br /> SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof <br /> (BASED ON ROOF o GABLE OR HIPPED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with <br /> NPE) 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 /> ii: Subtract the distance between the (BASED ON and the highest existing grade ad acent to <br /> SUBTRACTION 1 <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 De£ned building height <br /> EQUALS Defined building height <br /> y: <br /> Shorela�c� Qistrict IIlIC1t�D Permit t�eceived �vera � Lakeshore Setback MIIAet� Biuff <br /> C7 Yes � I�o � N/A � Yes � No <br /> �Yes � No C� Yes �o � N/A <br /> Permit Number: Setback: <br /> �tormwater Quality� Existin� Propos�cf �ariance Requireci CUP Required <br /> Overla District Tier Hardcover kEardcover <br /> � Yes C� No � Yes E� No <br /> Type(s): T e(s): <br /> �� � <br /> Updated: January 2013 ��'Yl� <br /> v:\forms\plan review checklist 2013.docx ��`�� <br />