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6'"��C� ������ ��I����,��� ��� t`��� ���������� /����►'����� <br /> . kddress: _ ��Q' �+�a���� permit PEo.• �'m�y�-0� 6� <br /> �escriptior�ofi v�ork: _f���' ���� Date Rec'd: r/ / <br /> Septic review by: ��. �- Ye � (� Dat�AAproved: '�'� • �� �� <br /> Zoning review by: Date ApProved:_ � � <br /> Buiiding review b�: ~ Dat�Approved: �� <br /> Grading review by: �-- ..:"�'�.�T: Date Approved: ���/��` <br /> Zoning District: � '" �` Zonin� File#: Reso#: Reso Date: <br /> �oning: Lot Area:��/AC NVEdth: Lot Coverage: SF _�% <br /> Sunrey Sutsmitfect: C� Yes D No Date of Surv�y: Revised date(�l� �� �ll ' <br /> Pro os8d Setbacks: � <br /> Front(Lake)� Rear(Stree�Q (� �i�E �o ( � � E � ) Other Buiiding� �1letiand <br /> e Slde �,*9 , <br /> �� _ ��'� � . :�� <br /> Defined Keight: ���� Peak F�eight: `'� •�'r FFE: �0� - � : <br /> � � FfE minus 6 feet:- �. (Existing�on#oa <br /> Perimeter(linear feetj= ���� g0�= ��� <br /> ° ''� ��L.F. below ' rade #of Stories � <br /> � <br /> FOR A BUILDING WITH A BRSE(J{EkT OR CRAYVL SPACf: FOR A BU1LDli�EG ON A SLAB FOUND �TIOt�: <br /> i�. � The distance between the lao+vest proposed Ttie distance between the top af <br /> 'Z START WITH floor(of the basp,m�M or crriwl spaae)and START W ITH gl b and the highest polnt of the <br /> the hlghesf ppfnt of YMe roof.` f. <br />� I�you have a... !f ou;tlave a... ' ' <br /> � GABLE OR HtPPED ROOF(no • GABLE OR HfPPEDROpF <br /> windows): SUbtract half the distance � (no windowg}: Subtracf haif <br /> betuveen the high�st pcfnt of the roef fFie distance between#he <br /> to the low poir�t of the Oorresponding � highest P�„t Of ihe roof fp <br /> �+ �� - SUBTI�ACTION gable pr htpped roof ` �the�ow po�nt of the <br /> (BASED ON � corresponding�abie nr <br /> ROOF TYPE � �LE OR HIPPED RDOF(with SUBTRACTION � hipped rop} <br /> � windows)� Subtract ha�f the`disfarice (BASED ON . GqHL�ORHIpPEp ROOF <br /> between the top of the highest ROOF'fYP�) � (wiih yr(ndouys�;,$ubiracl,• <br /> winduw and fhe highes�Potnt of the � haff the distaraoe be'�ireen <br /> roof _ � ` the tc�P of'tMe hig�est, . <br /> • ALL 07'HER ROOF TY�ES(1�8t, � winiiow and the higliest <br /> mansard.et��;.Nosubt�8c4on. � `p0intoftheroof - <br /> Sl1B7FiACTION Subtract ftte dista�ce betweetl the ' ` • � �bTHEFt ROOF TYPES <br /> (SASED ON : basement/crawl 8pace flpor�nd the .� $fl�at,���ard,etc):No <br /> ,�� EXi3TING highest exfstirtg grade adjaaent to�he bITION " Ad thp distance beMree�}he top <br /> GRA[�ES) foundation OR 1U feet(which�ever is less). (BASED ON of ab and 1he highe&t e�ds�fiing� <br /> �� ��,�► EQUA1-S Defined building heigM EXISTIWG g e adJaceM to the PouritlaUon. <br /> 6RADES <br /> � ; f EQI�AIS D ried buiWing height ' <br /> � � i <br /> Shoreland Distriat 11�CWb;Perniit .�"� A��ge�akeshore$etbacic Biu�Ff <br /> :; M�t? ,. <br /> 0 Yes �No Permit Number. � '�._ �� t7 YEs � No �N/A Yes No <br /> O N/A—see attached X ; Se ack: <br /> Stormwater Quallty Existing Nardcover �ro osed � <br /> Overlay Distr�ct (��o antl sfl �'���ccver Variance Requirec9 CUP Required <br /> 7ier circle one %and s � <br /> E7 Yes IVo i� Yes . �NQ <br /> Type(s): TYPe('.)� <br />; Updated: January 2U15 > <br /> z:lforms�plan review checklist 2015.docx <br />