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���� ������ ��������� ���. ��� ���������� � ���'������ <br /> a � !cJ� i �d O� �� �' .P�-�1� —����� <br /> �►ddress: Permif Mo.:___ <br /> Description of werk: _�e��� ������� ��dZ° S�� Date l�ec'd• � ��� ' �� <br /> � Septic review►by: �/� �—� Dat�Approved: -�""� <br /> Zoning reaiew b�: _ IJC��Q�"'� Dafe Approved: � �"" 0 � �� <br /> Bu�iding review by: I��� �'eiL �� Date Appcoveci: �• 1 ' i� <br /> Grading review bY. �v Date Approveci: ��Z�J 'j� <br /> Zoning District: L — �oning File#: Reso#: Reso Date: <br /> Zoning: I.ot Area:�� F AC I/�+idth: Lot Coverage: 1R� r6 Z4� SF Z.�_/o <br /> / o <br /> Survey Submitted: �Yes Q No Date of Survey: � � �Z '� Reviseci date(?)� <br /> Pro osed Setbacks: <br /> � Front(�e) Rear(S et) ( N iS3� E !N ) ( I� S E W ) Qther Butidings ►�etland <br /> �de Sicie � �<�.• <br /> �:�� ��� � �� �� � <br /> , �efir�ed Height; Peak l�eight: fFE: FFE min.us C feet= (Existing Contot <br /> Perimeter(linear feet)= 50°�= L.F. belov�r grade #of Stories <br /> fOR R BUILDlI�G WITH A BASE�+iEFlT OR CR�4WL 3PACE: FOR A BUILDING ON ASLAB FOtJNDATION: <br /> The dfsfance between the lowest proposed The distanee betwegn t e top pf <br /> START W ITM #loor(of the baselr�ent or uawl space)and START WITH ; slab and the highest point of the <br /> the highest point of the roof: ' �f. <br /> ff you have a... If yow,tiave a... <br /> ' + GABI�E OR HIPP£D ROOF <br /> • GABLE OR HIPPED ROOF(no (no windows): Subtract hal� <br /> windows): Subiract halFthe distance the distanEebetvueen the' <br /> between the-highest pofnt of f#�e►oof highest point of the roof to <br /> ' ' ' to the low point of the corresPonding . <br /> SUBTRACTION 9able or hipped roof the low poiht of the <br /> (BASED ON . corresponding gabie or <br /> RObF TYPE �BLE OR HIPPED RDOF(with SUB7RACTION hipped roof ; <br /> ) windows): Subtract half the diSiance (BASED ON . :. GABt�OR HIPPED RdOF <br /> between the top of the highest R40F TYPEj ' (wUh window�): 5�btrac{' ' <br /> , window antl the highest point of the haff(he diStance beiw�een <br /> ' ^°cf ; , the top of the`Mighest <br /> • ALL OTHER ROOF TYPES(flat, virindow and tF�e highest ., <br /> mansard,etc):No subtraCiion. point�f the root <br /> • ALL OTHER ROOF TYPES <br /> Si18TRACTION Subtract the tlistance betvtween the ° <br /> (Aat,mansard,etc):No <br /> (BASED ON basemenUcrawl space floor and the subfrac�ion. <br /> EXI�T�NG #3tgMest exis�ing gratle adjaceM to fhe A� QN dd the disfance between ttie.�op <br /> GRADES) foundatlon OR 10 fee2.(ydilchever ts less)." (Bq�Ep.QN df slab and ihe highest exlsting <br /> EQU S Definedbuilding Meight IXISTING grade adjaceM to thefoundatior�. <br /> . : ' ; GRifbES <br /> EQUALS Deflhed bufWing heigtit <br /> 3horeland DEstrict MC1lVD Rermit Average'Lakeshore 3etb�ck ���ft, <br /> Met? . < ; <br /> Yes 0 No Perrnit,Number. fl Yes � No ' NiA Q Yes o <br /> t�/A—see attaGhed Setb�ck: . <br /> Stormwater Quatity Proposed ` ' <br /> Overla �istrict Existing Hardcover <br /> y (%and sfl Hardcover Variance Requirec� CUP Required� <br /> Tiec circle one %and <br /> � ��. � )q.,3 aj0 r � Yes No 0 Yes � No <br /> 1 (2 ) 3 4 5 ��� � __— r TYPe(S)� Type(s): <br /> `./ 2�1�Z ;�� <br /> Updated: January 2015 <br /> z:\forms�pian review checklist 2015.dncx <br />