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��,�,� �:��t�� C�����c�c�� ��� ���� �r��������} f �,�� E��� <br /> A,dclress: � 6� O ,��c.��a� ` ��'�W'�° Permit I�o.. -� — C ��b <br /> Description of�rd��r6�: EX?Z�1�� �/� ���`�t�'�' Date Rec'�: � � ?-r3!�� <br /> Septic re�iew�y: �!!� Date Approved: <br /> Zoning reviewr by: t e� Date!�►ppraved: <br /> Building reviewr by: Date Approved: —1 g � �� <br /> Grading review by: �lf�- Date Approved: <br /> Zor�ing District: Zoning File#: Reso#: Re$o Da e: <br /> Z ning: Lot Area: SF/AC VJicith: Lot Covera�ge: F % <br /> �u Submitted: t7 Yes [� No Qate of St�rvey: Revised date . <br /> Pro os Setbacks: <br /> Front(L ej Rear(Street) � � S E 1M ) ( N S E Vi1 ) Other Buil ' gs Wetland <br /> Side Side <br /> Deffned Height; Peak Height: FFE: FFE minus eet= ( xisting Contour; <br /> Perimeter(1in�arfeet)= 50%= L.F. below grade of Stories <br /> FOR A BWLDING WITH A BASEME OR CRAWL SPACE: FOR A BUILDI ON A SLAB FOUNDATION: <br /> The nce between the lowest proposed The distance en the top of <br /> START WITH floor( basement or crawi space)and STAR7 WITH slab and the ht hest point of the <br /> the higMe int of the roof: roof. <br /> If you have a... If you have a.. <br /> • GABLE HIPPEDROOF <br /> + GABLE OR M ED ROOF(no (no wintl ):Subtract hatF ' <br /> windows): Subtr half the distance the distan between<the <br /> betwe8n the higlies ir�t of the roof highest rtt of the roof to <br /> to the low point of the espondirtg the low nt of the <br /> SUBTRACTION gable or hipped roof corzespon in <br /> g gable or <br /> (BASED ON . GABLE OR HIPPED ROOF( SUBTRACTION hipped <br /> ROOF TYPE) windows): Subtract half the d n` (BASED ON • GABLE O HIPPED ROOF <br /> between the top of the highe ROOF TYPE) (wfth wind ws): Subtract <br /> window and the highest p t of the ' half the di nce beriveen <br /> ropf the top of e highest <br /> ALL OTHER ROOF ES{fla� window a the highest <br /> ' pofnt of th roof <br /> mansard;etc):No ubtraction. . ALL OTH R ROO�TYPES <br /> SUBTRACTION SubVact the distan etween the (flat,mans rd,etc):No <br /> (BASED ON basemenUuawl s ce floor and the subtracdo . <br /> EXISTING highest exisUn rade adjacent to the ADDITION Add the distan between the top <br /> GRADES) foundation O 10 feet(whichever is less). ASED ON of slab and the h ghest existing <br /> EQUALS Defined 1lding height G�TI SG grade adjacent t the toundation. <br /> EQUAL De�fined bulldf� helgM : <br /> Shoreianc!District MCtND Permit Average Lakeshore Setback ' BI ff <br /> Niet? <br /> � Yes p o Permit Number. Q Yes � No p N/A � s ' Q No <br /> � N/A—see attached Setbac�: <br /> Stormwater ality Existing Harcicover Proposed <br /> Overiay cstrict o kardcover Variarsce ReQeaireci CUP Re uireci <br /> Tier ' le one (/o and sfl %and s <br /> 0 Yes [] No O Yes � No <br /> 1 2 3 4 5 TYPe(S)� TYPe(S)� <br /> Updated: January 2015 <br /> z:\formslplan review checklist 2015.docx <br />