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� r ` �_���:c�: ��:�;�F��z�.��� ��[�����Ec�� ��:�p [������ �'�r��:������� d ��.c�`c�c�,��:c�t� <br /> Ad�ress/PID/ Legal: _ � � �"�� � i� � � � �r` �-� <br /> , <br /> Description of�ork: 4 '� �C��� � �( � �� �' ��?:� ��, <br /> �e�a�ic c�wievN b�: � , Date�p�ac�vec�: ��• �O`f� <br /> Z�e�ina ��vie�r�y: ���e kppeovecl: �l' "r� `l f I� <br /> �ta@Eclie�g revie�t��: `�'� Date Appec�ecl: t - ��- 7�c ,� <br /> Crac�@r�g r�vievr b�a: ��.�e �at� ���Sr�vect: � �� /� <br /> Zoning File#: i2-3s5� Resolution#: Resolufion Date: <br /> �ae��e� Qi�g�icfi F�ee De �r�rre�nfi Po�f�fiice �ci�oo6 ��st�°Bcfi <br /> (�Z- e7 <br /> Zoning: Lot Area: t`�� '� � ,�•�1 SF/AC Width� '��C��"�2 V^� �� Depth: ��'C'' '`-� <br /> Survey Submitted: �es � No Date of Sunrey,/f�y �"Z,?�,r� �sr- 2�v����� <br /> Pro osed Setbacks: f����� <br /> Feoc�t(���j Rea��(�:�� l �' S � �) f E� S (�F !s�► � Qt��r�ui�c£6r�g� � �efia c� <br /> �i�e �ic�e e ����s <br /> `9`�5 �'�= G� � � �� � d 31�. c°s �"'�� �, f i <br /> � � rf E <br /> , , �m= r=,��i <br /> Building Defined Height: �� `"� Building Peak Height: �`• '�J #of Stories Ok?: � YE; <br /> �QR A BUILDIhG 1ft�iTH A BASEfifiEiJT OR CRAtA�L SPf�CE: FOR A BU1LDIkG Of�A SLl�B FOUMDATION: <br /> START WITH the distance between the basement floor/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 cornice of a flat roo� <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-ty� <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 eak of a itched roof and hi hest roof eak of a itched roof <br /> SUBTRACT the distance between the basement flooN crawl ADD the distance between the slab and the highe <br /> space floor and the highest existing grade within existin rade within the foundation <br /> the foundation or 10 feet,whichever is less. EQUALS Defined buildin hei ht <br /> • EQUALS Defined buildin hei ht <br /> Lot Coverage: G.� SF — %o . <br /> SE��retar�d 6istric� �Ct�i�Q� Rermi$t�e�eQv�d A�ee�a e Latc��hore ��fta�c� gi�a� <br /> � Yes � No � R�/A � Yes R�< <br /> �Yes � No � Yes � No �N/A <br /> Permit f�umber: Setback: <br /> Hae�6c�ve��:or�es �;�i�f€r� �cm asec� ��ri�nc� fde ca�r�ct C6�F t�e �i�ed <br /> �6' j.e,•� � f 3.0 ) `�• �:S Yes � IVo � Yes R�o <br /> �150' Type(s): Type(s): <br /> 250-500' v�5 ►�t+��./f r3� O�-.va.�.�r <br /> r:rw;.�fi,a: �-"/3t.�i.�� <br /> 500-1000' <br /> REi�iARKS (in-house): <br /> Updated: 09/11l2009 <br /> z�\forms�plan revieuv checklist.docx <br />