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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: �� �e�� �� ��17V i'C.� Permit No.: �� '~ �d�7J <br /> Description of work: �Z J7v� �( �Q� Date Rec'd: c7 ��V �� ` <br /> Septic review by:��NV�C/I � �U`Lt/�� Date Approved: �—' <br /> Zoning review by: Date Approved: �' �� <br /> Building review by: Date Approved: �� � <br /> Grading review by: 1 v� Date Approved: "—' <br /> Zoning District: ' � Zoning File#: �� '�qL� <br /> Resolution? Yes Reso#: 7 � Reso Date: 5•g�11 Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: �i�� �/AC Width: Structural Coverage: Z77�/•GISF � % <br /> Survey Submitted: 0 Yes �No Date of Survey: Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: � N /None pro 0 <br /> Proposed Setbacks: <br /> 1 3o ta I o <br />�� F nt(Lake) R r(Street) ( I� S E W ) ( N S E W ) Other Buildings Wetland <br /> Side �ide <br /> l�0 � �3 3S' 37 ' <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor a efined Top of �a� <br /> Roofi` See "buildin hei ht" efinition : <br /> First Floor Elevation f m buildin lans : (b) <br /> Highest Existing g�`ound level (per survey) or 10' ��� <br /> above lowest�: round level, whichever is lower: <br /> Differenc�between b and c : (d) r <br /> De ined Buildin Hei ht(a) - (d): �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> s � No Permit Number: 0 Yes No 0 N/A � Yes <br /> No <br /> /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 /> g •�'j� $,��] Yes � No � Yes No <br /> 1 2 3 4 5 C� c �S� <br /> T pe(s : Type(s): <br /> c� <br /> N�c. s����- <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />