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E�'��� ������ ������6�� ��� ��� ���������� ! ����i���'�'�� <br /> Address: '� �8����C� t��� Permit No.• ��-��� <br /> . � • - <br /> Desc��ipticn of vvork: � � Date Rec'd• � � • �'�� <br /> , <br /> Septic review bY. ""' Date/�pproved: '"__." <br /> Zoning review bY� 'Date APAroved: '�'j • <br /> Build'ong review by: � Date Approved: `' ` <br />` C�rading review bY: !�l � Date Approved: ��� '�s " <br /> Zoning District: Zonir�g F�Is#: Reso#: ! Reso Date: <br /> , <br /> Zoning:Lot Area�: S�/AC Width: Lot Coverage: SF % <br /> , <br /> Survey Submitted: es �' No Date of Survey: _ Revi�ed date(?)� <br /> Pro osed Setbacks: <br /> Front(Lake) Rear(Street) ( �d S E YV ) ( N S E IAl ) Other Bulidings 1lVetland <br /> � Side Side ; <br /> Defineci Heigf�t: Pe�k`t�eight: FF�: FFE mtnus 6 feet=�_(Ezist[�g Cor�to� <br /> Per6meter(linear feet)=. 30%_ ; L:F. belovu�grade #of Stories <br /> �OR A BUILDING WITH A BASEMENT OR CRAW1.SPACE: �OR A BUILDING ON A SLAB FOUNDATION: <br /> d(stance UeMreen trie'lowest proposed h8 distanoe 6etween tt�e top of, <br /> START W ITFi floor(of the baserqeM or p�awl SP�e)and START WITH ap and thb highest Polat of.tti� <br />' the fiighest p;iint of the roqF. �, ' <br /> If you hade a:.. ybu"have�... , � <br /> � � GABl.E.OR HIPP�DROOF(ao ��� � " ����OR HIPPPcD ROOF <br /> • windows): SubtrBct I�alf the disfanee � {no windouys): Subtiact hal� : <br /> betkveen th,�hfghest point ofi tMe rpof 1 the d�stance betwe�n ihe <br /> to the7bw pc>irK of th�correspondin� � �9��t o�f the roo3#o <br /> SUBTRACTION gable or hipped roof: ' th�row <br /> , i corresA�nding gable or <br />, (SASED ON . G/EBL�OR HIFPEb�ROOF(with SUBTRACTION � hiPped roof ` <br /> ROOF TYPE) wfndows): SuMract half the distanCe (BASED QN . Gi4BLE 4R HII�F'gf3 ROdF <br />� between,the kop of th@ highest . ; `ROOK TYPE. � = <br /> ) �wtth�rirMorysj.5vbtr�et „ , <br /> window and the h i ghest pofnt of�e � ' haff the di�tan�e bbhYeen <br /> �f } the:tPp of•d�e hlghebx <br /> • ALL OTHER ROOF T'YPES(flat, 1 ��oW ana the fiigtiest <br /> . mansard�etc):No sutitractiort. .`{, , pointrr�ffUie ruof <br /> •' /liL QTH�R RODF�YPES . <br />. SUBtRACTI Subtract fhe distance between the (fitaY man�rd,,etej:tJb <br />, . (BASED C7N basemen#kfawt space fio4c�and:th� .:S <br /> EXISTING hlghest enisting gradRadJac�ent to the �fftON ;A #hedisfat�ee*belweenllie tcp , <br /> GfZAqES) fuundabon OR 10#�t(whicJieVer is less). � <br /> (BASED�N of�Iab ant�fh�iil9Mest e�isting�. <br /> f 1lf1LS De�ined b�iidin fiei ht � EXIS�ING <br /> 9 9 fRADCS ` g. de adjaceM to the fdundatiqr�. <br /> fGtIAL'$ � O ped bultding he7ght <br /> Shoretand D�strict MCIaYYD Perinit A��9e takes�ore Setb�ck � 8tuff <br />. Met? <br /> � Yes �No Permi#Number: -' G Yes O No N/A� .�[7_'Yes No <br /> �. N/A—see attacher� � a�ic: . <br />: , z , n . . •. <br /> Stormwater Quality Exfsting HBrdcov�r �'roposed <br /> Overlay District �a�o and sfl �artfcover Variance Requireci � CUP Required <br /> Tier eir�le one %�hd s � <br /> � Yes No `Yes No <br /> 1 2: 3 4 5 Type(s).' ` TYPe��)� <br /> Updated: January 2015 <br /> z:\forms�plan review checklist 2015.docx ' <br />