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�'��� ���r�e� ��ec���s� fo� �ev� S�r�cfur�s / �c��@����s <br /> Address/PID/Legal: _ p��� � �. �-� � e �j ('� �,.� �, !cl (�*-�.�i <br /> Description of work: �'/L�-�';� r f� � -�--'�,, "�Q����Q � <br /> Septic review by: Date Approved: <br /> Zoning revievd by: Date Approved: <br /> , Building ceview by: w Date Approved•_ `��- ( t— (� <br /> Grading review by: Date Approved: <br /> Zoning File#: Resolution#: � Resolutian Date: <br /> Zonin District Fire De artment Post Office Schaol District <br /> : Zoning: Lot Area: SF/AC Width: Depth: <br /> Survey Submitted: 0 Yes Q No Date of Swrvey: <br /> Pro osed Setbacks: <br /> front(Lake) Rear(Streeti) ( N � � W ); ( N S E W ) Other$uildings Wetland <br /> Side: Side <br /> Building Defined Heigt�t: Buildirhg Peak Height: . #of Stories Ok?: C! YES <br /> FOR A BUILDING WITH A.BASEMENT OR CRAWL SPACE; � �OR A BUlLDiNG ON A SUkB FOUNDATiON: <br /> � START WITH the distance beiween the basement floorl t�rawl START ' t#�e distance between the slab and the highe: <br /> space floor and the highest roof peak,the top of WITH coo#peak,the top of the comice of a flat roof, <br /> the comice of a flat roo#,the deck litte of a: the decfic line af a rnansard roof,or�he <br /> � mar�sard roof,or tMe uppermost point on a tound uppermost point on a round oc other arch-typ <br /> or other arch- ropf roof <br /> SUBTRACT half the distanee between the h�ghest window and . SUBTRACT half tMe distance betw�n the highest windov� <br /> hi hest roof eak of a ched roof and hi est roof`e�k o#� itGhed roof <br /> SUBTRACT the distance betw�en the basement floor!c#�awl ADD the distance betwee�?Jie slab and tHe higheF <br /> space floor and t�e highest ezistirig grade�hfn existirl tade.w�thin.t�he fo�ntlatipn <br /> tt�e foundation or 10 feet,which�ver is less� EQUALS Defin�d tiiiitdin h�i ht <br /> EQtJALS D+efined buildin h ` ht - - � � . <br /> �at Coverage: �f - a�o <br /> , Shoreiand Distrtct MCWi�'Permit Recehred Avera e Lakeshore Settia�k ` Bluff <br /> ` t3 Yes G No N/A � D Yes . � No <br /> � Ct Yes fl No ` � Yes , i7 No 13 N/A <br /> � Pem�it Nurr�ber: _ i S�tback' <br /> ; Hardcoyer�ones Existin Pro ed Vari�r�c� I�e uited: �U Re uir�d <br /> 0-75' . ; i7 Yes G No � Yes i� No . <br /> � 75 250' ` , Typ��s): Ty�e�sa; <br /> ; <br /> 250-500' <br /> , 500-1000' _ , <br /> � REMARKS (in-house): <br /> Updated: 09/11/2009 <br /> z:lformslplan review chedclist.doac <br />