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� �����.�� ���,�����u� �������..��� ��� f����� ���������� � I?�4.�'�����'�'�� <br /> Address/P�rrr�it�umb�e: � ���� � �" i Y � � <br /> Descrip�iior� ���or6�: ��`� � <br /> Se�ti� redEe�r by: Date Appro��c�: L � r' � � <br /> ,` r, , / f r- , . <br /> Zoning re�ie�v by: ° � D�fie Approvec�: •f��7 <br /> Builair�g re�iewr by: Date f�pprove�: ���� — ��3 <br /> GradEn� revievv by�: �t�r D�te Apprcvet�: 9 / <br /> ZoniRg Di�tr6ct:��� Zoning Fiie�B: Reso#: Reso Qate: <br /> Zoning: Lot Area: S /AC l�6icfth: l.oE C�verage: SF % <br /> �urvey�ubmittec£: es � No Date�f Survey: 'B "� Revised date � : <br /> Fro o�ecE Setb�cks: 4 c't �`� <br /> Fr�nt( �) F�e�r��t? ( � S E 1�11 ) (� S E 1�iP ) Ofiher uiicfings lidet[aRd <br /> tcEe Stc�e }�y,yv <br /> �� � � � �� <br /> a <br /> Qe�ned He��ht: � � P ` k f�eight: ��� FFE: FFE mirtus 6 feet= (Ex t6n C r� e�f <br /> Perime�er(iEr�ear feet) _ �0°�_ #of Sfarie� Qk? �YES <br /> FOR A BUILDING WITH fn BASEfifiENT OR CRAVirt SPACE: <br /> The dis#ance between the lowest FOR A BUILDIPIG ON A SLAB FOUPIDATIOPI: <br /> START WITH proposed floor(of the basement or crawl <br /> space)and the highest point of the roof. START WffH The distance between the top of siab and <br /> If you have a... <br /> Uie highest poir�t of the rooi. <br /> If you have a... <br /> • GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no <br /> windows): Subtract half the windows): Subtract half ihe distanc <br /> distance between the highest point between the Aighest point of the roc <br /> of the roof to the low point of the <br /> P��f to the low pant of the coRespondin� <br /> SUBTRACTION cortesponding gable or hi SWBTRACTION " gable or hipped roof <br /> (BASED ON ROOF . (`,ABLE OR HIPPED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with <br /> TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distanc <br /> distance betwee�the top of the between the top of the highest <br /> highest window and the highest window and the highest poirrt of the <br /> point of the roof roof <br /> ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flet; <br /> • mansard,etc):No subtraction. mansard etc:No subtraction. <br /> ADDITION Add the distance between the top of slab <br /> SUBTRACTION Subtract the distance between the (BASED ON and the hi hest existin <br /> (BASED ON EXISTING �semenUcrawl spaoe floor and the EXISTIN6 the foundation. g g�de adjaceM tc <br /> GRADES) highest e�usting grade adjacent to the GRADES <br /> foundabon OR 10 feet(whichever is less). EQUALS Deflned building heigM <br /> EQUALS Deflned building heigM <br /> Shoretanci Distric� C1A/E3 Permit Received l�vera e Lakeshoce Setback�tiet? Biuff <br /> Yes Q No � N/A 0 Yes No <br /> Yes Q No �3 �� � Yes � No �A <br /> Permit Number: .. Setback: <br /> Stormwrater Quality Etti��ir�g P�rcpos�d W�r6ance t�equireef CUP Requireci <br /> Oveel� �{�tftCt YE�P F�aK9cover Harcicover <br /> � Yes No Q Xes No <br /> 4 � � � �' `�'� TYPe(S)� Type(s). <br /> Updated: January 2013 .� <br /> v:\forms�plan review checklist 2013.docx <br /> ��2.�� ������ �� <br />