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. PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: "� 1 �r� i V 1� . �- ��� �� Permit No.: �1�7 'W�� <br /> Description of work: N �VYv� Date Rec'd: ���"T-� � <br /> Septic review by: ��,w'�t� '�- �rV►TW Date Approved: <br /> Zoning review by: Date Approved: �/ �Ic/��� <br /> Building review by: �" � � Date Approved: C7� � <br /> Grading review by: Date Approved: IZ r�+�'1 �� <br /> Zoning District: Zoning File#: ^~ <br /> Resolution? Yes Reso#: — Reso Date: Signed: Yes No Resolution� <br /> � <br /> Zoning: Lot Area: L2. S /AC Width:�� Structural Coverage: �_SF �—' % <br /> Survey Submitted: �Yes � No Date of Survey: �'�� '�� Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: ��(I� QC��{lY�� � No/None proposed <br /> Pro osed Setbacks: <br /> Front�) Rear(S�) (� S E W ) ( N � E W ) Other Buildings Wetland <br /> Side Side <br /> L� , , , 3Z <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and defined Top of �a� � <br /> Roof See "buildin hei ht" definition : <br /> First Floor Elevation from buildin lans : (b) !,�1;-�, ;. <br /> Highest Existing ground level (per survey) or 10' <br /> above lowest round level, whichever is lower: ��� I�- . ". .' <br /> Difference between b and c : (d) �i , � <br /> � i f�!. <br /> Defined Buildin Hei ht(a -(d): �e� �; +":".: <br /> ����� <br /> Shoreland District MCWD Permit � Average Lakeshore Setback g�uff <br /> Met? <br /> � Yes �No Permit Number: r"� ... ' � Yes � No �N/A � Ye 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 No � Yes No <br /> 1 2 3 4Q 5 �,�-�"—' Type(s): Type(s): <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />