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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> Address: Z�Y 'C"t l�U� �� K(a Permit No.: �J�7 ' �`[�✓ <br /> Description of work: 1��.'�.�V`— Date Rec'd: ��� �� <br /> Septic review by: ���V� �-- YV a 1�I Date Approved: �' <br /> Zoning review by: Date Approved: � �� �� <br /> Building review by: ` + - Date Approved��l � <br /> � <br /> Grading review by: IIv� Date Approved: <br /> Zoning District: `��� Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Res /NA <br /> Zoning: Lot Area: �� l�� SF/AC Width: Structural Coverage: SF % <br /> Survey Submitted: �Yes 0 No Date of Survey: ����� Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: <br /> �nt(Lake) r(Street) ( N �S E W ) ( N S E W ) Other Buildings Wetland <br /> Side Side <br /> 'n �, <br /> W <br /> Buildinq Heiqht Analvsis: <br /> Distance Between First Floor and d � d Top of �a� � <br /> Roof See "buildin hei ht" de ' � ion : <br /> First Floor Elevation fro uildin lans : (b) <br /> Highest Existing gr d level (per survey) or 10' ��� <br /> above lowest nd level, whichever is lower: � <br /> Difference tween b and c : (d) <br /> D ' ed Buildin Hei ht a - d : �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback Bluff <br /> Met? <br /> Yes � No Permit Number: Yes � No 0 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 /> Z3.(Q3 �,,.�.� � Yes No � Yes No <br /> (�1 2 3 4 5 2 S� �„�Z. cS TYPe(S). Type(s). <br /> L/ 1� � <br /> Updated: October 2016 <br /> v:\forms\plan review checklist 10-2016.docx <br />