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' P�LAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: 1Z-1 / W.� � Permit No.: ���l/ � 0�3�7 <br /> Description of work: �� �� Date Rec'd: �� ��p ��Y� <br /> Septic review by: ��/w-�1� �-- YV Q�U' Date Approved: �—� <br /> Zoning review by: Date Approved: � ' �-' � <br /> %" ' �v z � <br /> Building review by: Date Approved: <br /> Grading review by: �i/ Date Approved: �.-t'rY;fi ���_ <br /> Zoning District: ��L Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: ►� F/AC Width: Structural Coverage: �SF ��-•�� % <br /> Survey Submitted: es 0 No Date of Survey: V1•L�' � Y� Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: IvO� SU, � t7'V�1 � � No/None proposed <br /> Pro osed Setbacks: ��� I � Q'��� A^Y P�O�°� ��� ���� a �n� �J P��� <br /> I� l0 <br /> Front(L e) Rear(S et) ( N S � W ) ( N S E �) Other Buildings Wetland <br /> Si Side <br /> 3 . ' l� ' �c�� �a h' �rU <br /> 3� . k� ht�w t�io�r� S u �c._- <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and defined Top of �a� <br /> Roof* See "buildin hei ht" definition : �• <br /> First Floor Elevation from buildin lans): (b) � L <br /> Highest Existing ground level (per survey) or 10' (�� �3. <br /> above lowest round level, whichever is lower: <br /> Difference between b and c : (d) � <br /> Defined Buildin Hei ht (a) -(d : �e� �q•Z- <br /> Shoreland District MCWD Permit Average Lakeshore Setback gluff <br /> Met? <br /> Yes 0 No Permit Number: l� - � Yes 0 No N/A � Ye No <br /> � N/A-see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and sf °/a and s <br /> �L,.,YCJ01'� Z�S •9-�QjO 0 Yes No 0 Yes No <br /> 1 � 3 4 5 / �j$S� ��i �P��S� TYpe(S)� TYPe(S)� <br /> W� <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />