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�'���,� �������' �E����E�[��' ���: ���� ��`�C���C��.�� �' �,�'���°��t�� <br /> Adc�ressiPer�tt PEum�er: 3Oy� �►�rH �'t-to�.�, �(J fL <br /> Description of�ack: l�A���,U �1� <br /> Septic reviewr by: �t11+� aate Approv�d: <br /> : Zoning review by: Nt� Date Appcovecf, <br /> Buildin� review by_ � Dafie Approved• ��2 Z'-�y <br /> Gracfing review by: i`'//a- Date Approvecl: <br /> Zaning District: Zonir�g File#:' F�eso#: Reso�ate: <br /> �o ng: Lot Area: SF/AC 1+�+idth: �.ot Coverage: SF /o <br /> Surve S�ebmitted: L� Yes Q No Date of�urvey: Rekised dat ? : <br /> Pra os Setbscks: <br /> Front(La Rear(��reet} E � �ide w 1 t � Side � ) �ther��fltli : t��tfand <br /> Defilaed Height: Pea4s Height: �FE: �FE minus 6 �et= (Ex€�ti�rg Con#our <br /> Perim�ter(linear feet)= 5Q%_ �of Stoeies Ok? Q YES <br /> F�R k BUIL•DlNG WITH A BASEIiflE OR CRAIA�C SPACE; <br /> Ttie di ce between tl�e towest FOR A BUI ING ON A SLAB FOWND/iTiOlat: - <br /> START WITH pro oor(of the basement or crawl <br /> space)an highest poin#oi the roof. 3TART WITH �distance between the top o1 slab and <br /> If you haye a.. the hi�hest polnt of the roof. . <br /> � • GABLE OR IRP@D ROO.F(no H you hava a... <br /> windaw$); Su : haH the • GABLE OR WIPPED Et00F•(no <br /> distance be e highest{�oiM `winduws): SubtracE MaH the:distana <br /> of the roof to the' int of the ' between the highest poiM of the roo <br /> po g gable hipped roof to the low pant ofihe Co�espondin� <br /> SU87RACTION corres ndin SUBTRACTION gable or hipped roof <br /> {TM EED.ON ROOF . GABLE OR MIP,PEb RO (with ' (BAS�D ON • GABtE OR HIPP�D RpDF(with <br /> windows),$ubhact half the ROOF TYPE) windows): Subtract half the distana <br /> dist9nee between the top of th : behNeeh the top ot th8 highest <br /> , highest window and the highest window and the.highest point of the <br /> point of the roof rool _ <br /> � • ALL OTHER ROOF TYPE$( • ALL OTHER ROOF TYPES(flat, <br /> ' mansard,etcj�Nosubtracti . rt�an rd etc:i�o suhtra ' . <br /> ADDI�'ION Adii the dfata�ce befiroee�the tep.of sla5 <br /> SubYract the distance between e 9 e�dstin9 9rede adlacent fa <br /> SUBTRACTION (BASED ON end thehl hest <br /> {BASED ON EXISTING baserhenticr8wl spaCe floor d the EXISTING tAe�oundation. <br /> GRADES) higheat ebsting grade ad' nf to the GRAUES <br /> foundation OR 10 feet( ichever is less). E UALS Defined building hel�ht <br /> EQUAL5 D n�d butlding fiei <br /> �hore(anc� Distcict �iAC [� Pere�it lR�ceived Avee� e Lakesho Setts�ck AAet? �luff <br /> C7 es 0 No � N!A t� Yes t� �!o <br /> CI Yes � No C� Yes 6� No N/A <br /> rmit Number: . Setback: <br /> Stormv�ater Qv�tity Ezi�ti�g Pro�Qsed �ariance Requisec� CU equiret€ <br /> O�reria Dist�icf Tie �Eardcaver Nardc�ver <br /> � Yes � No � Ye 0 R�o <br /> Type(s): TYPe�s)_ <br /> Updated: J ary 2013 �� ��v� <br /> v:lforms n review checkiist 2013.docx <br />