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:: <br /> r , <br /> ; <br /> P�a� l�evievv �he�k�i�� ��r ��w �t����c��°e� � ����ti��� <br /> t Address/ PID/ Legal: y�� �� ,,�� � �'� ��(-� �- <br /> = Description of work: ' � ; • ��� � <br /> Septic review by: � � Date Approved: �� .g d ' �� <br /> Zonin� review by: �u�,�S date Approved: �' �7• � � <br /> �� � ,s , <br /> �uilding review by: �� ,{� '.� �- Date Approv�c�:� T � �' �`"`"�`� � <br /> Grading reviewr by: ��� Date Approv�d: �" ��? ' � Z-. <br /> Zoning File#: Resolution#: Resolution Date: <br /> � Zonin District Fire Department Po�t Office School District <br /> � <br /> Zoning: Lot Area: c�� �,� •� �' SF/AC Width: Depth: <br /> J Survey Submitted: Yes � No Date of Survey: _ ��� �t� <br /> Pro osed Setbacks: <br /> Front (Lake) R�ae(Street) � � S � � ) B � � E �) Qgher Buifciings Wetland <br /> � Sic�e Sicle <br /> 5 <br /> � � ��� �� �� <br /> Building Defined Height: Building Peak Height: #of Stories Ok?: Q YES <br /> FOR A BUILDING INITH A BASEMENT OR CRAWL SPACE: FOR A BUILQIMG ON A SLkB FOUNDRTIOI�: <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 behveen the highest window and SUBTRACT half the distance between 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 bui�din hei ht <br /> � <br /> Lot Coverage: SF % <br /> Shoreland District MCWD Perrnit Received Avera e Lakeshore S�tback �luf€ <br /> `', ❑ Yes [] No 0 N/A � Yes No <br /> Q Yes �No 0 Yes � No �/A <br /> Permit Number: Setback: <br /> Nardcover�anes Exi��@n Praposed Varianc� Reauie CUP Requirec� <br /> 0-75' � Yes No @� Yes No <br /> 75-250' Type(s): Type(s): <br /> 250-500' <br /> 500-'f 000' <br /> REMARKS (in-house): <br /> x„ <br /> Upd ated: 09/11/2009 <br /> z:\forms\plan review checklist.docx <br />