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<br /> � ' �C.I�E� ��t�e�C� ���6eCEL.Ea7�� �Q� t��� ���t��w�t���� l �������'t�F.C'J
<br /> � /�ldcires�/Pertnit�Eumber: �
<br /> . �d��" 1 � i�.��� � ��t�-��
<br /> D�scripticn of worlt: ��.,���� ��r�� _
<br /> Septic review bY: - /� � Date ApprovecE: '" � �
<br /> ' �oning review bY� � �1.� Date Approved: Q' r.� -(�
<br /> � �uilding revievr bY: .•,-` Da#e Approved: 4�'L'�-.C j �
<br /> , ; . ,
<br /> � Grading review bY� l� � Date APproved:
<br /> � ;
<br /> + Zoning District: '' Zoning F�te#: , Reso#: Reso Date:
<br /> ; : . , _. :.�.
<br /> � -
<br /> , Zonfng:Lot Area: 3F/AC Vilidth: Lat Coverage: SF _%.
<br /> ` Sunrey Submitted: es � No Date cf`Sunre : ` �
<br /> � y "�`'�' �� Revised da#e�� ., ��'�3
<br /> , ,
<br /> : Pro o$ed Setbac#csc ' '. `
<br /> ; � " .
<br /> ; Front(Lake)_ Rear(�treet) ( � S e$ . ) f N Side � � Other Builcfings Wetland
<br /> � ` � -
<br /> ; � , �. .. � � �.. F � y �� � . -
<br /> . .
<br /> ,. ,�. . > . .. , . . ,
<br /> � —. ,.. - ., - . . a �-� .�. :. .� - �. .' ..
<br /> f �. . . . ..,, . . ' ' ' . � . _ , ' . ..
<br /> De�fned Height: Pe�k Height. ,_� FfE: ` -. FFE�inus 6#eet= ` .(Existing�ontoui
<br /> . .
<br /> ,
<br /> . � , �
<br /> ,Perirnetec(finear feet�= 5�"�5= ' � ' #of Steries Qk? �YES . . �
<br /> ; ,.. ; ; :
<br /> FOR A BWIDING WlT�1 A BASEMENT OR CRAl1VL SPACE: �
<br /> F "I'he distance bgtweerrthe-IoweSt � . �
<br /> 4 � STAR7IMTH proposed floor{of the basemen4 ��A BUILDING ON A SLAB FOUMDATIOt�:"
<br /> . sPece),entl the highest poirn r94f. � � START WITH The tifstance belwee�!he toprof sl8b and
<br /> , ;,; _ If you have a... the Fiighesf part ofthe rcofi�•
<br /> • ; GABLE a P�D RDQF(no�, ff you have a.: .
<br /> � -.GABLE�R}��PP�P RDOF(na
<br /> � `windows [ibtract half the ' vnndowsj: �utltra�t hal�,�he iii§tanc
<br /> dista . ,between�e highest qM
<br /> p betweer�;the h�ghiest prn�t of the roc
<br /> ; ' e roof tQ the Ibw poin#of tMe` , ' �
<br /> � �o the I�irir po�t o�fhe dim
<br /> r -SUBTRAC710N. . rresponding gabte o�hipPed rdof SUBTRACTION �abl or hf ���
<br /> (�3ASED QN�tOOP � PP�rooi
<br /> � "'l1fPE �ABLE OR HIPpED ROOF('Mt#� ' (gAS�D ON � GABLE,OR NIPPED i�,DF(with,;
<br /> � windows) SubVact haN the .; RObF TYPE) xnndoJvs�: Si�bt�a�t he�8�e'cl(Btenc
<br /> , dfstance betweE�n the Eop ofi the� ; bQ�nree�the�top�f the i�yhesf ".
<br /> � ;highes�window and the highest fi , . windc!N,�,t�hi9heSt'Pol�if of�E
<br /> � .p�int of tfie ro4f "s"`tdt3f
<br /> + '. �LL O'fiH�R R0'OF'i'YPES(fla'�� ;� • , AL�.Ol"HER,ROb� &,(fi�t� .
<br /> � `'` , ma►ieafd,�tcj No s�b'traetior� : ,`m�� '-� 1�a� : .
<br /> - �ubtra e d tence betweer�tlae ADDITIOIV Adci the dist�qCe�tw8e�fihe qf s atf
<br /> � `.Sue �`fUDN x , , (BAS�t�ON ; ,� nd tiie hist�est e�d6�c�g gratle t�ri2 t�
<br /> '( ' fD ON IXISTIN� .,bs§emenUcrawl sP�9e floor�nd the , FJC S'fING tlie•f0un aacn>., , : � _
<br /> b,ES�` = hiflhe�t ewst�n9 9r8de`adJ$c�mYto the � � � `Eg -r:;, � _ -;
<br /> j ,: �t?undatwn qR�10 feef(whichever is le�s}:� .� Q'tfI0.L� Defin�d bui itng heigti�
<br /> _ . >,. . , ;
<br /> ` � �4UA1.&-� �. ,�6etined�builtling h@igHt . � � ��- �� " � ` . : � _
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<br /> . . ; . „ .,
<br /> 1 � � : � � � �; .. . , �
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<br /> : Sho nd i�trict ° MC1�lD Peimit ReceiV� - J�/�yera e Lat�eshore Setback�iltet� - Bluff�, "
<br /> ' G Yes � D Nt� �'N/A � ' 0 Yes . , �- No
<br /> Yes rG No , G Yes 13 No N/A
<br /> Permit Number. � . Sefback:
<br /> , - r ,. .. :.
<br /> � - � .
<br /> , Starmwater 4uaiity Existing . Proposed
<br /> �
<br /> ' OvBMa Distriat Tier fiardcover Harcicover Varian�e Rec�aired CL�P Required `
<br /> t7 Yes No O Yes . No
<br /> � �,�, ,,.,__t ,�, �—t�� �� .
<br /> . ; +�� .�,�. �;,;� Type(s): Type(s).
<br /> Updated: January 2013 �-�.��'" ,� � �� •� �-<
<br /> v:\forms�plan review checkiist 2013.docx ,� ._,,,'l;d
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