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, PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS <br /> 'Address: ���5"l �J� ��' Permit No.: Z��� �' �b5��/ <br /> Description of work: �D(.�-�--» Date Rec'd: �' �� ' i / <br /> Septic review by: <ivVv �/ �- � Date Approved: �� <br /> Zoning review by: Date Approved: <br /> .�. <br /> Building review by: ` Date Approved: f _ <br /> Grading review by: Date Approved: - <br /> Zoning District: -' � Zoning File#: <br /> Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coverage: �_SF �•_� a % <br /> Survey Submitted: � Yes � No Date of Survey: Revised date(?): <br /> Landscape plan submitted? � Yes Landscaper: 0 No/None proposed <br /> Pro osed Setbacks: <br /> Front( e) Rear(Stf� ( N S E W � ( N S E W�O Other Buildings Wetland <br /> Side Side <br /> Buildinp Heiqht Anaivsis: <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) <br /> Highest Existing ground level (per survey) or 10' ��� <br /> above lowest round level, whichever is lower: <br /> Difference between b and c : (d) <br /> Defined Buildin Hei ht(a) -(d): �e� <br /> Shoreland District MCWD Permit Average Lakeshore Setback g�uff <br /> Met? <br /> Yes � No Permit Number: 0 Yes 0 No �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 /> ��� f� • ��:t';�� � Yes No 0 Yes No <br /> 1 ( �J 3 4 5 32.q� s �g�� S v Type(s): Type(s): <br /> �� � <br /> Updated: October 2016 <br /> v:\forms�plan review checklist 10-2016.docx <br />