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� ��AN REVIEW CH�CKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �� JTt�- Permit No.: �� , ���7 <br /> Description of work: S Date Rec'd: �2'2-1 '��p <br /> ; <br /> Septic review by: T � Date Approved: <br /> / <br /> Zoning review by: Date Approved: � �� � � <br /> / � �, <br /> Building review by: Date Approved:����`'Li_ <br /> Grading review by: Date Approved: 3�eL/� <br /> Zoning District: 1..�. �L' Zoning File#: ��' 3o IS <br /> Resolution? Yes Reso#:��v�l- l-rceso Date: � '< < (Q , Signed: Yes �Resolution/NA <br /> Zoning: Lot Area: F AC Width: � Structural Coverage: Z-Z-��SF 1• V % <br /> /� 22aq t�.9 <br /> Survey Submitted: �Yes � No Date of Survey: Revised date(?): Zl�/�7 <br /> Landscape plan submitted? 0 Yes Landscaper: +1Gtf d J�°f (d�P o� No/None proposed :� <br /> , � , p.n G��IfJ'f . <br /> Pro osed Setbacks: . <br /> F nt(Lake) Rear(S�t) `I ( N S � W ) :-( N S E ; W ) Other Buildings Wetland <br /> Side � Side " <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and defined Top of , . <br /> Roof'` See "buildin hei ht" definition : �a� �`� �� <br /> First Floor �levation (from buildin plans : (b) 3, <br /> Highest Existing ground level (per survey) or 10' :�,., -. <br /> above lowest round level, whichever is lower: ��� -�'��:`t�f°�" <br /> Difference between b and c : (d) ( c'. <br /> Defined Building Hei ht (a) - (d): �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> Permit Number: `� _�"1 Yes 0 No 0 N/A � Yes <br /> Yes � No � No <br /> � N/A-see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overtay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and s % and s <br /> � 2 3 4 5 ����n�� �'"T•Z�"`� Yes � No 0 Yes o <br /> �'L�� ��� S� ype�s � �S TYPe(S)� <br /> s�l't+t�Jura�- CO��ru�� <br /> Updated: October 2016 <br /> ��4- area� <br /> v:\forms�plan review checklist 10-2016.docx <br />