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��[�� ����.������ ��°���[�.���� ��� ������ ��:�c���c��9�� � ���`�€�c���� <br /> Address/ PID/LegaL � ( �C.� (ev ti� I � J� � �� V a <br /> Description of work: <br /> Se�rtic ce�iew bY� �/ '� Dafe�p�arQved: � '� ��'� � <br /> Zon�ng revie�v�b�►: _ Date A�aproved: l� �r <br /> �uElcf@ng revie�by: _���!''" D�te Ap�rovecE: `'� ..�� (,� 1 � <br /> Grading revie�+t��: �ate kppro�ed: <br /> Zoning File#: Resoiution#: Resolution Date: <br /> �or�ir� District Fire Qe artment Ros��'ice �C�'60Q{ I}IS1PEGg <br /> Zoning: Lot Area: SF/AC Width: Depth: <br /> Survey Submitted: � Yes Q No Date of Sunrey: <br /> Pro osed Setbacks: <br /> ront f.ak�j Re�r(�tree�) ( � � E l� j ( i� S E l�9 } �ther B�itdir�g� l�tett�rtd <br /> s°.•� �' S[t£e <br /> � <br /> Building Defined Heaght: Building Peak Height: #of Stories Ok?: � YE� <br /> FOR A BUtLDING WITH A BASERAENT OR CRAM/L SPL�CE: FOR A BUILDING ON.R SLAB FOUN�ATIOId: <br /> START WITH the distance between the basement flooN crawl START the distance between the slab and the highe <br /> space floor and the highest roof peak,the top of WITH roof peak,the top of the comice of a flat roof <br /> the comice of a flat roof,the deck line of a the deck line of a mansard roof,or the <br /> mansard roQf,or the uppermost poinf on a round uppermost point on a round or other arch-tyF <br /> or other arch- e roof roof <br /> SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest windo� <br /> hi hest roof e.ak of a itched roof and hi #�.est roof eak of a itched roof <br /> SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and fhe Mighe <br /> space floor and the highest existing grade within existin rade within the foundation <br /> the foundation or 10 feet,whicheveris less. EQUALS Defined buildin hei ht <br /> EQUALS Definetl buildin hei ht <br /> Lot Coverage: SF % <br /> �ltorefanc!Qistrict P�RCi�'C3 E�er�nit R�ceide� Avera e L�keshore Sett� k �E� <br /> E� Yes � �[o Cl N/A 0 Yes <br /> es !� No 0 Yes 0 No N/A <br /> Permit Number. Setback: <br /> t�arcfcaver Zones �xisfin t�re osee� �ariance Re �irec€ Cll� R uir d <br /> 0-75' ���� � Yes o CT Yes No <br /> 75-250' ��'�' � a TYpe(S)� Type(s): <br /> 250-500' � �� <br /> 500-�000' ���y�, �.�� <br /> REMARKS (in-house): � <br /> Updated: 09/11/2009 <br /> z�\forms�plan review checklist.docx <br />