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. , . ���� E���c�� ��������� ���° f��� ��r����c�� � �c����F��� <br /> Address!PID/Legal: � �� ` �'�'�-- ��C�-� � <br /> Description of work: ���� ����� <br /> Se�tic r�view+�y: � , D��te RRpeode�:� �" , <br /> P <br /> Zor�Eng revie�►+t�y: E�ate Approvecf: �f/ <br /> Bu�lc�ing revi�w by: Dat�Appr�ved � " � "�ti Z_ <br /> Gracfing reviev✓by: `f�i � Dafe�provecl: ���. <br /> Zoning �ile#: Resolution#: Resolution Date: <br /> Zon�r� f?istrict F�re C3e artmer�t Po��affice School District <br /> Zoning: Lot Area SF/AC Width: Depth: <br /> Survey Submitted: �s L� No Date of Sunrey: �"���� <br /> Pro osed Setbacks: <br /> Front(L� I�ear(Stre�tj � �J S E � _ ( PE S' 1N ) Other Building �ile#IancE <br /> S�cf� • e. <br /> t(�t ' �(�� � <br /> . � � <br /> Building Defined Height: Building Peak Height: � #of Stories Ok2: YE� <br /> FOR A BUILDIf�G WITH A BASfMENT OR CRAWL SPACE: FOR A BUILDING ON A SL/1B FOUNDATION: <br /> START WITH the distance befinreen the basement floor/crawl START the distance between the slab and the highe <br /> space floor and the highest roof peak,the top of VVITH roof peak,the top of the comice of a flat rooi <br /> the cornice of a flat roof,the deck line of a the deck line of a mansard roof,or the <br /> mansard roof,or the uppermost point on a.round uppermost point on a round or other arch-tyE <br /> or other arch- e roof roof <br /> SUB� half the distance between the highest window and SUBTRACT half the distance be#ween tfie highest windo� <br /> i hi hest roof ' ak of a itched roof and hi fiest roof eak of a itched roofi <br /> �^ „� SUBTRAi T the distance bet�veen the basement floor/crawl � ADD the distance befween#he slab and the highe <br /> l� ,, �� space floor and the highest existing grade within existin rade within the foundation <br /> the foundation or 10 feet,whiehever is less. EQUALS Defi�ed buildin hei l�f <br /> EQUAL$ Defined buildin hei ht' <br /> Lot Coverage: ---��SF ' _ %o <br /> Sheretanc� District h�fCN4�D i�errnit Rece�ve� Avera 'e L.ake�hore Setback ����� <br /> O Yes C! No � N/A � Yes Nc <br /> �es � No CI Yes No !� NfA <br /> ,/ Permii Number. Setb�ck: <br /> � {�aPcicdver Zone�. Existin Pro osed �fariance Re ui d CUP Re �ired <br /> 0-75' � Yes No � Yes o <br /> 75-250' � TYPe(s): Type�S�; <br /> 250=500' <br /> �[��,��� 1�- <br /> 500-1000' � <br /> REMARKS (in-house): <br /> Updated: 09/11/2009 <br /> z:\forms�plan review checklist.docx <br />