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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: � � l • Permit No.: �l7 —('��T <br /> Description of work: ��/Vy ttU�l(.�,Q � Date Rec'd: � '[t!�•�7 <br /> Septic review by: ,,U/V� y-- YV�,� Date Approved: '�� <br /> Zoning review by: Date Approved: � '�2' �� <br /> Building review by: b r.���vc,�� Date Approved: � `� � "a-D�� <br /> Grading review by: /�-f1�� ��L'�1��(�l�r(/�-�� Date Approved: �-.- �9'`- �� <br /> Zoning District: � Zoning File#: `—'� <br /> Resolution? Yes Reso#: `—" Reso Date: -"' Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: �� SF/AC Width: Z�� Structural Coverage: ^ SF �— % <br /> Survey Submitted: �Yes 0 No Date of Survey: ���' 1 I Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: <br /> � � <br /> Front(L R Nrt S e � ( � S E W ( N � E W ) Other Buildings Wetland <br /> . OV� Side Side ,14► — �$ ' <br /> 2-�5 � 114' 121 ' � ' �l- '�g ' <br /> Buildinq Heiqht Analvsis: �— � / <br /> '�'—io3 ' <br /> Distance Between First Floor and defined Top of � � I� � <br /> Roof'` See "buildin hei ht" definition : a � <br /> First Floor Elevation from buildin lans : (b) �, ' <br /> Highest Existing ground level (per survey) or 10' (c) l0��-1 <br /> above lowest round level, whichever is lower: <br /> Difference between b and c : (d) l I�J(� <br /> Defined Buildin Hei ht(a) d): � � � �e� Z7•5 <br /> , � � <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> - � Yes No Permit Number: " -- � � Yes 0 No N/A � Ye No <br /> � 0 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 No � Yes No <br /> 1 2 3 4 5 ,�,�/�//� � ,.--�—�-� Type(s): Type(s): <br /> n v� � t, <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />