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. ��A� FZE\/��VV CH'ECK�IST FQR I�IEVV �T�lJCT�JF�ES / 14DD1TIONS <br /> Address: � ���.�' ��� Permit No.: �� ���� <br /> Description of work: �� � � ''1�� Date Rec'd: �•��" <br /> �eptic review by: �-��� Dat� �approved: '�"" <br /> Zor�Br�� Ee�6��r k��: � k�� E3�4e�pprQved: _�'� '� <br /> �uildin� re�i�� b�° ����. �;��.�'��:���- Date Qpprodec�: �� `�'? �' ���:�s <br /> f�rading reviev�a by: `'��" . '� �ate Approved: � E� �° �1� <br /> , <br /> �onin� Di�trie�: � ����� ��rr`sa�g �Ele#: �eso #�e Res� �ate: <br /> Zot�in�: Lot Area: � ��� S /AC �'i�th: -�������� r '' __ SF % <br /> Survey Submitted: �es Q No Date of Survey: �'�� °� Revised date(?) �° Q�:� < . <br /> �� <br /> �'; Proposed �etbacks: __ <br /> Front e) Ftear(St t)`` ( N � E W ) ( °�l�, S E W�� Other Buildings Wetland � <br /> �` �y �ide Sicie <br /> ;- ,1 � ° <br /> �,-. <br /> � :l � � �� , <br /> Defined FBeight: - Peaic l�eight. ;:- ..� FFE: .., - FFE minu� f feet=_ (Existing Contou� <br /> ( ) � �s < ` r --% L.F. belo�v grade #of Stories � <br /> Perimeter linear feet = � i� • 50% _ <br /> FOR A BUILDING WITli A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUPiDATION: <br /> The distance between the lowest proposed The distance between the top of <br /> � -, -- START W ITH floor(of the basement or crawl space)and START W ITH slab and the highest point of the <br /> i the highest point of the roof. rocf. <br /> If you have a... If you have a. . <br /> e GABLE OR HIPPED ROOF <br /> � • GABLE OR HIPPED ROOF(no (no windows): Subtract half <br /> windows): Subtract half the distance the distance between the <br /> between the highest point of the roof highest point of the roof to <br /> �� •' to the low point of the corresponding the low point of the <br /> SUBTRACTION gable or hipped roof <br /> � corresponding gable or <br /> � �; . (BASED ON . GABLE OR HIPPED ROOF(with SUBTRACTION hipped roof <br /> ROOF TYPE) windows): Subtract half the distance (BASED ON � GABLE OR HIPPED ROOF <br /> between the top of the highest RQOF TYPE) (with windows): Subtract <br /> window and the highest point of the half the distance betweer <br /> roof the top of the highest <br /> � ALL OTHER ROOF TYPES(flat, window and the highest <br /> ���� mansard,etc):No subtraction. point of the roof <br /> ____ e ALL OTHER ROOF TYPES <br /> SUBTRACTION Subtract the distance beriveen the (flat,mansard,etc):No <br /> .._ (BASED ON basemenUcrawl space floor and the subtraction. <br /> ' � ��, � ,r,�1 EXISTING highest existing grade adjacent to the ADDITION Add the distance between the top <br /> � GRADES) foundation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing <br /> , EQUALS Defined building height EXISTIP�G grade adjacent to the foundation. <br /> GRADES <br /> � ' EQUALS Defined buildin5 height <br /> Shoreland �igtrict �GVVD Permit Average Lakeshore Setback Bluff <br /> IViet? <br /> Permit Number: � , - �'-�=� 0 Yes � No ��N!A � Yes � No <br /> �Yes � No � `'��' <br /> � N!A—see attached Setback: <br /> �tdrmwat�r f�a�alitlF ����t@e�� B�ae�����r Praposeci <br /> Qverla�r 6i��rE�� o FEarc�c�e�er i����ar����e�uore� CUP Re��ir�� <br /> Ti ier circle one (�o and s� %and s <br /> ' <,-`_ �. • � � � Yes �`t�o � Yes � �No <br /> 1 2 3 � 5 �`}�, � ' � �YPe(s)� TYPe(s)� <br /> �� Updated: January 2015 <br /> z:\forms\plan review checklist 2015.docx <br />