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� ���� ������ ������R�� ��� ��� ���������� � ���E����� <br /> � <br /> acfdress/Per�nit�Eumber: ��./ �[�"��'� � <br /> Descr@ption of vNork: ��%�(������ ��� 6 S <br /> Septic revlew bY: Date Approved: <br /> Zoning reviev✓by: � � Date Approved: <br /> Building review by: Date Approved.� � <br /> Grading review by: � �-e�ii�1 Date Approved: i 'Z t"0 <br /> Zonin� Di�trict: Zoning File#: Re�o�R: Reso Date: <br /> Zoning:Lot Area: SF/AC 1PY�c�th: Lot Ccverage: SF %o ; <br /> Surrrey Submitted: 0 Yes _ � No Date of Surve�: _ Revised date(?):' <br /> Pro osed Setbacks: <br /> �ront(L.ake) Rear(Street) ( �' gi�e � � � N Side � � �her Buildings 1llfetl�nd <br /> Defined Height: Reak Height:;;;_ F�E: fFE rninus 6 feet= (�xisting,�ontoui <br /> Rerimeter(linear fieet)= SQ�%,: #of Stories Ok? C7 YES � <br /> FOR A BUILDINC3IMTH A BASEMENT OR CRAWL 3PA�E: � <br />� The distance between Yh$lawest FOR A BUlLDING ON A$LAB fOUNDATION: . '� � <br /> ' START WITH proppsed floor(of the b�B�nent or crewl <br /> space)and the highest p�int of the roof. START WI'FH The diat8r►ce between the top,rof siab and <br /> If you have a... the higtiest poi�t'oi�he roof: , <br /> • fABLE OR HIRPL'�.ROOP(no If you f�a4e a... : <br /> • GABLE OR hHPPED RG}OF(no <br /> wimdows):'SuGt�G�,tiatt the wir�tlt�w8): SpbtraCt h�ii��e distanc <br /> distance between tFie highest poiM be�vveeA the high�st peii' ofthe ra <br /> of the roof to�e IoNi point of the tq#he Iow ppirrt.c�fhg , r�espondin <br />� SUBTRACTION correspooding ggbl�i1r hipped roof SFJBTRPcCT10N ' qabienr hipped lotlf `. . <br /> ETM E�D O�I RObF . GqBlf OR HIPP��#t00F(with (BASED ON . Cw46L€OR NIPPEfl R b�.(witM <br /> windowsj:���Subhac�fk:alf the � ROOF TYR�) witSdovrsj e�ubttact ha. U�disf�nt <br />� � disfanGebetweeh#��lopoftMe � � � be�rtthe�dpoithe` 'g1�, ����� <br /> high�st windo�rv 2u�l;fhe highesf mtititlpw and,fhe highest�oiM of3he <br /> ��point of the ropt ���� � � rvof ` � <br />' . ALL 4THER ROAF'�'YPES(flak� .. ` ` • ALL OTHER RbO�TYi��S(flat, <br /> : rnansard,etc}.No '_btracGon. mansant ete:,Nbsu `on. <br /> /1q ITION� Add the tlista�c�belweer�th.t�of�b <br /> SubtrBCt ffie disfanc� " n the <br /> SUBTRAC170N (�ASED OIV and th8'highest @xlatl�g,grad adjacent'b <br /> :(BA3ED ON EXIST.ING �°m8"U�"f spaoe flopr and the �XI9TING the fountlaN4n. <br /> GRADES) highest existing grade a�j�icsent to the GRADES ` , j <br /> foundation OR 10 feet{dV�ichever is iess)• EQUALS Peflnetl piiilding hetght� � <br /> CQl7ALS Deflnetl building hetgtit.:�. - <br /> � <br /> � � . . .� � . . . . � .. . . . . � . . . . : i.� _ . <br /> . . ��. p� . :� . �.� .�: �...,�1 �. � . <br /> _ <br /> Shorelan,d District MCMID Pen�I:i�Received Avera e Lakeshore Setback Met7� Btu <br />, � Yes � No i3 N/A ; ; G Yes ; t7 No <br /> i7 Yes : � No , ~ �3 Yes � No 17 N/A <br /> Permix Number.'`. Setback: � <br /> Stormwater Quaiity �xisting � Proposed � : <br /> Overla District Ter Ffi�rticover Hardcover V�riance F�eQuired CUP Required <br /> � Yes t] No C! l�es G No <br /> TYPe(S)� TYpe(S): ; � <br /> Updafed: January 2013 <br /> v:\forms�plan review checklist 2013:docx <br />