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, ' , � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: � �� �N( � Permit No.: �-�✓( ! ~ �� /J <br /> Description of work: ��r(,� ' 1,C�Cl.y�.. Date Rec'd: �,J 'Lc=7 '�� <br /> Septic review by: Date Approved: <br /> Zoning review by: '-' Date Approved: J ` ' � <br /> Building review by: Date Approved: z'� � <br /> Grading review by: �� __� Date Approved: `—� <br /> Zoning District: ��"�L7 Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/ NA <br /> Zoning: Lot Area: Y� �F AC Width: Structural Coverage: SF % <br /> Survey Submitted: �es � No Date of Survey: 3 '2- '� � Revised date(?): <br /> Landscape plan submitted? 0 Yes Landscaper: � No/None proposed <br /> Pro osed Setbacks: <br /> Front(L e) Rear(Str ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> `V l � • V� � <br /> Buildinq Heiaht Analvsis: <br /> Distance Between First Floor and define Top of �a� <br /> Roof See "buildin hei ht" definitio . <br /> First Floor Elevation from buil ' lans : (b) <br /> Highest Existing ground el (per survey) or 10' ��� ' <br /> above lowest roun vel, whichever is lower: <br /> Difference betw n b and c : (d) <br /> Defined uilding Hei ht (a) -(d): �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> I,� Yes � No Permit Number: `(0 .��� � Yes 0 No N/A � Ye No <br /> � � � N/A-see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> Overlay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one % and s °/o and s <br /> �,(j,ZQ� 0 Yes No � Yes o <br /> 1 � 3 4 5 �.p�r,� Type(s): Type(s): <br /> 0"�C>'t�� <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />