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, P"��E� ��Fc'L�1�� ���4eL'����� �V'� ��� ���V�i����� � �L6���C�Q��� <br /> . . / 1 <br /> � �,ddr�ss: GU� ��l r���21.�' ,j'Q�C�, �a� Per�nit t�o.: �.��J — ��D{13�. <br /> -g�,,� , <br /> � Description of vvork:. .�1���� ���Q� . D�t� R�c'd: �.'�..tJ"�,'�J <br /> C e�,4� — ` <br /> i Septic review by: ./Q!�!/ , � el�' Date Approved: <br /> Zonirtg review by: . �. . Date Approved:` '1'� <br /> � <br /> � Building review by. � . (��,�i�,. � .�. Date Approved; , � <br /> Grading review by: "'� Date Approved: ""'""` <br /> Zoning Qistricf: Zoning Eile#c Reso#: Reso.Date: <br /> ; Z�ning: Lot i4rea: SF/AG Wiclth:< Lot:Co�erage: ` SF % <br /> Survey SubmiftecE: Q Yes �No Date of�urvey: Revised da�e(?): - <br /> � �. _ , : _ <br /> � Pro osed Sefbacks: _ . <br /> � . : <br /> � � Frc�rst{take) Re�r(�treetj ( � Side � ) t � Side ` w � �C?ther Buildings Wet�and <br /> , <br /> . <br /> � <br /> Aefingd Heigt�t: Peak Height: F�E: �FE rninus 6 feet= ,(E�cistir�g'Conto+ <br /> � P�r�meter(linea.r feetj= 50%"- ' . L.F.b�low grac3e .�of Storiss <br /> 1°Ott A BOILDIkG tMITH A BASEMENT.OR"CRAWL SPACE: FOR AB�JiLQING ON A SLAB.fOUNDATIQN: <br /> � The disfsnce,between the bwesi.ptqposed . fi{ve distanee between ihe top of, <br /> � START WITH flbor Eof 3he baseriienk or cFaw1 space)and � STAI'tT WI7H slab and ttie Mighest;point ofi#�e <br /> tfie fiighest point of.itie rpof.. '. �(. <br /> It you have a... -_. If you have:a , : <br /> • GA�LE OR HIP{�ED R�OF <br /> • GABLE OR HIPPED ROOF(no (no�indowsj: Subt{act half <br /> ' windows)� Subtract haif.the distance, <br /> � � beNvaen the highest point oi the roof . �+�d,�nCe betweqn ttie . <br /> G hi�}pest point of the roDf:t�. <br /> . to ihe low pbint oi the corresponding <br /> 3UBTRACTIDN 9able or hipped roof. . ihe low poin4 o�;tFte <br /> corte.sponc�irrg gable or , <br /> , . :_ '(BASED ON.:" . �ABLE OR HiPPED ROflF(wRb' " ' S�UBTWICTIQN hippe�roQf � <br /> ROOF TYPE) windows):_S�btraCt hatF the distance (BA�FD ON r . . G�46i.�OR F11PP�Q�ODF° <br /> ; between the lop of the,Mighesi` • ROQF�CYPE) Ewith.tnr(ridouvs):-SUbtraet. , <br /> � w(#rd'bw�nd the h(g6est polntyof the half�e distance betwean <br /> � � roof � � ����, ' �� the t,cs�of"the tiighest.� � <br /> wlnddwant3 t{ae hlg`F9'est <br /> � - . AiL�O'fHFR ROO�'1'YPES tflat, poitit of tfi+e�oqf . : <br /> �. . mansard,etc):.No subtractior�. • <ALL OTHEit'ROO�TYPES <br /> '5UBTRACTION SubVac#tfie dis#ance b�e � en'trie (flat mahsard.:etc):No .� <br /> ! . (SASG�OM baseme`nY/erawl space iloocantl fhe r � <br /> _ EXISTING ti' hast exisUn S � '� �, <br /> �9 9 9rade adl��ent to#Fie �4DDITION Ad�ttie�Istance'tiet�rve8n the;top <br /> ; � � � � ��fyRAD��) � � foundaUon OR 10�feet(whichever fs less). ��: �(�SER ON� of stab antl�the hl h�§t�x�stfng� <br /> 9 <br /> S D�fined building h�ig'i ' IST.ING. =, $rade adjacenY to the fouhda(ion� <br /> , ` . ` . ' ,'' 'GfiAbES <br /> '�LlllAI.S;: Defln�dbuiiding height ' <br /> � . <br /> ' Average Lake�ho�e etbac� <br /> Shoreland District MCWD Perrnit j Bluff' <br /> :-., . � - : , , ,. .... _ . .' fiii�t?� . : . . <br /> ` -t] Yes � No ` Permit Number, �� � Yes i1 No�� - 1�/A O .Yes No <br /> � N/A—see attached � Setb�ck: <br /> Starmwater Quaiity Exi�ting Warctco�er Proposed <br /> Overlay Disfirict o Hardcover Variance Required CllP Required <br /> � Tier circle one. (/o and s� %and s , � <br /> Q Yes No 6 Yes No <br /> 1 2 3 4 5 . ���c� �� � TYPe(S)' TYP�(s): <br /> � Updated: January 2015 <br /> z:\formslplan review checklist 2015.docx . <br />