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. �`C�,C'ti�C 6 tL�l`1.��! �'� L������� ��L4 L��L'C' �� L k�l.dWC��L��4D' � ��4F�Y�[�.Ct�:� <br /> �.ddress: ��.�' �'c�i�e�-B�lf.@: �6A�C Permit Flo.: <br /> , <br /> �escri�tioc� o�wrorE�: ��,�+oge�.►�m��� "�' '� � e��� �•r���aEeRec'd: <br /> �eptic re�iev�t��►: _ ��f� ��te�►pprovect: <br /> Zon@�g eevie�hy: u' � Qat�/�pRroved: <br /> � <br /> Build�ng r�vie�a b�+: �afie�proved: S -�1� ��3 f� <br /> �radf�g re�riew►�y: �°� Date�pprovecl: <br /> onirt� Districfi: �onir�g File#: Reso#: R�sa D�te: <br /> Z ing: Laf�,rea: 8F/AC V4,'idth:� tot Coderage= SF % <br /> Surv � 5ubrr�ift�c�: � Yes � t�o Qate of�urvey: Revised da ? : <br /> E�ro ose Setl��cks: <br /> �rcr�t(La ) E�ear(Street) � �" � E �" ? ( � � E � ) Q�her ildirigs f�iEetland <br /> �ieE� Side <br /> E3e�ned Height: �eaEc E��igt�t: FFE: �FE mi s 6 f�et= (Existir�g Conto <br /> �erime#�r(Eir��ar feet)= 50%= L.E=. belornr grad� #of Staries <br /> FOR P:BUILL`IPECC VJtTF9 A BASEFhE OR CRA1'�L SPACE: �aR�.B BIRlG Ok A SLAB FOUNDftTIDN: <br /> The nce between the lowest proposed The distance between the top of <br /> START VNITH filoor(af basement or crawl spa�e)and START W.ffH slab and the highest point of the <br /> the highes oint of the roof. roof. <br /> If you have a... ff you have a... <br /> GABLE OR PED ROOF(no • GABLE OR HIPPED ROOF <br /> � windows); Sub ct half the distance (no windows): 8ubtracthalf <br /> between the high polni of the ro the distance between.ths <br /> to the low pant of th rres�pon ',g highest point of the roof to <br /> SUBTRACTION gable or hipped roof the law point of the <br /> (BASED ON corresponding gadte or <br /> ROOF TYPE � �BLE OR HIPPED ROO with SUBTRACTiON t�ipped roof <br /> ) windows}: SubtracthaH e nce (BASED ON .' GABLE OR HIPPED ROQF <br /> petweera the top of th` ighest ROOF TYPE) (with windows): SubtracY <br /> window and the hi st point of half ihe distance between <br /> roof the top of the,highe.st <br /> e ALL OTHER F TYPES{flat, window andthe highest <br /> ' mansaril, );No subtractiori, point of the roof <br /> SUBTRACTION Subt�act the sta�ce betwee�tMe ' ALL OTHER ROOF TYPES <br /> (BASED ON baseme rawl'space floor and the (flat,mansard,ets):No <br /> EXISTING highes Istir�9 grade adjacent fo the subtracfion. <br /> ADDITI N Add the distance between fhe iop <br /> GRADES) foun iion OR 10 feet(whichevei is less). (BASED ON of siab and the highest existing <br /> EQUALS ned bulidin hei ht EXISTING <br /> g .9 GRADES 9rade adjacent to the foundation. <br /> EQUAtS Defined building heighi <br /> �har�larrc� f3i�tr' t NECtRID Fermit Avera�e Lakeshore tback Bl�ff <br /> ��ta <br /> t3 Yes Q No Permit Number. � Yes � No C3 N Q Yes 13 No <br /> 0 N/A—see attached etback: <br /> Stormv�r �er Quality ��Esting�EaecEcQver pr�posed <br /> O�e y�istricfi o Fiarc6cover l�ariance Re uirecf <br /> Ti circle one (/o and sf} %and s q C �eQuir�c4 <br /> . <br /> � Yes C] No � Yes � No <br /> 2 3 4 5 Type(s): TYPe(s): <br /> Updated: January 2015 <br /> z:\formslplan review checklist 2015.docx ��.���,�;,��� <br /> � <br />