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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: LJ t "1.� ���C� �-Q��. Permit No.: �(� ���� <br /> Description of work: �t( T1�('�� Date Rec'd: �"�'l� <br /> Septic review by: �{'�(�I �-- C�� � Date Approved: �—" <br /> Zoning review by: Date Approved: �'�� <br /> Building review by: Date Approved: <br /> Grading review by:�,�L4A�lN� l��,V�'U► � Date Approved: 5• �' � ` <br /> Zoning District: '�� Zoning File#: --' <br /> Resolution? Yes Reso#: --� Reso Date: '—' Signed: Yes No Resolutior� <br /> Zoning: Lot Area:��AC Width: Structural Coverage: Z.��•�F 15,�0�0 % <br /> �J 2p?O Qil��o�-'' <br /> Survey Submitted: Y�Yes � No Date of Survey: 3'� '�7 Revised date(?l: <br /> Landscape plan submitted? G Yes Landscaper: � /None proposed <br /> Pro osed Setbacks: <br /> F�(Lake) R�(Street)� ( N S E W p ( N S E �) Other Buildings Wetland <br /> Si� Side <br /> � � � r ��i , <br /> Buildins� Heis�ht Anaivsis: r / <br /> V <br /> Distance Befinreen First Floor and d ed Top of � � <br /> Roof See "buildin hei ht" de ' ion : a <br /> First Floor Elevation fro ildin lans : (b) <br /> Highest Existing gr d level (per survey) or 10' ��� <br /> above lowest r nd level, whichever is lower: <br /> Difference een b and c : <br /> Defined Buildin Hei ht a - d : �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> Permit Number: �es 0 No O N/A � Yes <br /> T�es 0 No No <br /> –see attached Setback: <br /> Stormwater Quality Existing Proposed <br /> OveMay District Tier Hardcover Hardcover Variance Required CUP Required <br /> circle one %and s %and s <br /> �1 2 3 4 5 «�� 0 �,��OZQ G Yes o G Yes No <br /> ���S� 3���.3 b� Type�s�� TyPe�S�' <br /> Updated: Odober 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />