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. PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> � Address: � . L� Permit No.: ��7 y „� �� <br /> Description of work: ' Date Rec'd: �' p '� / <br /> Septic review by: �XAIV� � �l�1 VI Date Ap� ed ZQ���� �� <br /> Zoning review by: Date Approved: � �� �� <br /> Building review by: Date Approved: � f <br /> Grading review by: ;�L.__ Date Approved: �3 rlB/� <br /> Zoning District: � Zoning File#: `—' <br /> Resolution? Yes Reso#: -- Reso Date: — Signed: Yes No Resolution I NA <br /> /,� � ► <br /> Zoning: Lot Area: lf/��� SF AC Width: �J 3 Structural Coverage: ��SF � % <br /> Survey Submitted: �Yes � No Date of Survey: 2' 3 '�� Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: � �� ��` JU'�V <br /> Front(L e) Rear(S t) (� S E W ) ( N � E W ) Other Buildings Wetland <br /> �� Side `-S`ide <br /> � r � � � �� � Z7. 2 �`� �?� <br /> Buildina Heiqht Analvsis: <br /> Distance Between First Floor and defined of �a� � <br /> Roof See "buildin hei ht" definitio : <br /> First Floor Elevation from buil � lans : (b) <br /> Highest Existing groun vel (per survey) or 10' ��� <br /> above lowest rou evel, whichever is lower: <br /> Difference be en b and c : (d) <br /> Define Buildin Hei ht (a - (d): , � � � �� �- <br /> � .� <br /> 1 � <br /> ������ <br /> Shoreland District MCWD Permit � verage Lakeshore Setback g�uff <br /> Met? <br /> 0 Yes 0 No N/A O Yes <br /> 0 Yes �No Permit Number: � �O 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 % and s <br /> � Yes o � Yes No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />