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���� ������ �����l���� �'�� ��� ���������� f ��'�����!�� <br /> I�dcEress: � � �`4.����� ��� Permit t�o.: �1�J� -�d�.�v _ <br /> Descripfiion of v�rork: ��11� -IU Date�l�ec'd: � `��`��'.,)' , <br /> Septic review bY� D�te�provec9: � � <br /> Zoning review by: t '� ' r Date Approved: � z� � <br /> Buiiding review+bY� � Qate Approved: � �.� l <br /> Grading r�vieHr bY- Date Approved: �i i <br />' Zoning Distcict: '( _ Zoning File#: Reso#: Reso Date: <br /> Zoning: Lot Area:_ 1� /AC Width: Lot Coverage: SF % <br /> S�rvey Submitted: �es t� No Date of;Survey: � •2�• (� Revised date(�)� <br /> Pro osed Setbacks: <br /> Front��'� Rear(S�eet) (�t S E W ) ( 1� �S � E 4N ) Other Buildings 1�Vletiand <br /> Side '6i'tle <br /> f � � . �� � � � ���� <br /> ?�,,' ,{ 't� <br /> Defined Height: Peak Height: FFE '�' �• ;: �FE minus 6 feet= t fa:' :'�=�# (�xisting Conto� <br /> ,.� <br /> , <br /> Perimeter(Finear feet) _ _> !`' 50%= ��',�. L,F. below grade #�of S�ories {. <br /> M1 :X`_ Z, � ; ;•• • 1 :;;� � t ; <br /> FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BU(LDII�G Old A SLAB FOUNDATION: <br /> The dlstance between tfre lowest pruposed The distanoe between e Wp of <br /> _'; , �. START W ITH floor(of the basemeM or crawl space)and �TAR'f WITH siab and tfte:highest t of the <br /> i.f �y: the highestpolM of the roof. ' f. <br /> If you have a... � lf you have a....' , f <br /> GABLE OR HIPPED ROOF(no • GABLE OR WIPP RODF <br /> • wintlows): Subtract half tlie disfance (no windaws,,�,S, traet half <br />' between the hiphest pofnYof tMe roof the dist�oe be en the <br /> . , ` hi�he�fPcifrtoff' ronito <br /> . ^�' to the low p.oint of the corresponding � <br /> '- ' SUBTRACTION 9abie or hipped roof : ;-itie fow point of th <br />� (BASED ON . �qBLE OR HIPPED ROOF{with' SUBTR,4CTION :. ����g aa te or <br /> , ROOF TYPE), windows): Subtract half 41ie distance (BASED ON , ' . Ga�iE OR HIP� U RQOF <br /> -r'� betweer�the top of the htghest ROOF T'YpL�) (wfth winticiWs)," q�racc <br /> . , �. > � <br /> ' window and the'highest point of Bie j" half the di§lanoe `tin�en <br /> roof the4op of th�ttigti st <br /> • ALL OTHER ROQF fiYPES{flat, " vukic7onD and#he hi hest <br /> pointofthe roof " <br /> mansard,etc):No subUaction. { J : <br /> • ALL OTti�R RQ�TYP�S <br /> ' SUBi'R,ACTION Subtract the distar�ce b�iween thie (fiat�inarisaril,$ No <br /> { {,. (BAS�D ON basement/crawl space floor and the � ,��', suMra�n. <br /> . a ��;,a EXIS�'INC� highest existing grade adJasent to tha ' A6DRiON Add the stance�e n' "e top <br /> , � <br />�'� � GRAQES) towndation OR 1D feet(whictiever is less). j, (BAS�D ON of sla�i and.U�e highest xis8ng ' <br /> , , � T. EQiJALS Defined building height F�(ISTING grade adjaceM to fhe fo ntlatlorr� ' <br /> ' i.�� GRAQ�S �. <br /> `�"'°� `^1 F„G1UAL3 . Deflned byfWing tieig <br /> � o-.� <br /> 1 , . - : .,. <br /> Shoreland District MEWD Perrnit ?p►v�ra$e Lakesllore Setback Bluff � <br /> _ ; ; Met? _, <br /> 0 Yes �o Permit Number. �� -� � Yes Q No /A ' � Yes � o <br /> O N/A-see�ttached � 5etbaek: <br /> Stormwater Quality Proposed ' <br /> Overla District Existing Hardcover . <br /> y (%and sf� kardcover Variance Required CUP Requirec�. <br /> Tier circle one %o and s ` <br /> 0 Yes No Li Yes �No <br /> 1 : 2 3 � 5 �����,,,o� Type�S�. Type�s�� <br /> i`�J�l <br /> l <br /> Updated: January 2015 ', <br /> z:\fortnslplan review checklist 2015.docx <br />