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' � ���� ������ �����C���t ��c° ��� ��r������� i A�����c��� <br /> Address/PID/Legal: _ �J``� � � e�� � j "'r,/�+� �— <br /> Description of work: L' <br /> SeRtic review by: Date Approved: ��� l�'` 1 � <br /> �oning review by: Date Appro�ed: ��J� � :� <br /> BuElciing review bY� D�te Approved:: � - °l --( ( <br /> �a�cling reviewe by: �R�� �1'�(.0 Iry 1 ��Y� Date Approved: F�/�Lt;�. �'�77�1�f <br /> Zoning File#: � R�solution#: � Resoiution Date: <br /> Zonfn District Fire De artment Rast Of�ce �chool District <br /> Zoning: Lot Area: ' �i� a �al _�F�RC�y��dth: Depth: <br /> Sunrey Submitted: �Yes � No � Date of Survey: �t, � �� �� � <br /> Pro osed Sctbacks: � <br /> Front ak�j Rear(Str�et) � � � E lM � { Pt S � W 1 Ott�er Bu.ilctings 1Rle�tland <br /> Side Side <br /> �'1/� (� .�� <br /> ! <br /> Building �ned Height:��_ Building Peak Height; ��� #of Staries ?: YE� <br /> FOR A BUILDING YIfITH A BASEMENT OR CftAWL SPACE: FOR A BU{LDING ON A SLAS FOUNDATION: <br /> START WITH fhe distance befinreen#he basement floor/eraw! START the distance between the slab and the highe <br /> space floor.and the highest roof peak,the fvp of WITH roof peak,the top af the cornice of a flat roof <br /> the comice of a flat roof,the deck line of a , the deck line of a mansard roo#,-or the <br /> � mansard roof,or the upperrnost point on a round ' upperm�sst.point on a round or other arch-ty� <br /> or other arch- e roof ` roof : <br /> SUSTRACT hal#the distance between the highest window and SUBTRAC'� . half the distance betvueen the highest windo� <br /> hi hest roof ak of a itct�ed roof and hi hest roof- eak ofi a itched roaf <br /> SUBTRACT " tMe dista�ce between the basement tloor/crawl ADD fhe dist�nce between the slab�andthe�highe <br /> space floor and the Mighest ewsting:grade wi#hin : exi t�n rade within�he,found�tior� <br /> the foundation br 40 feet,whichever is les.s. EQUAL� . Defin�d bu�ld'n hei ht < <br /> EQUAL:S Defined bupdin hei ht <br /> ' Lot Coverage: �i�''i� S� �� o�p <br /> Sh.oretand District MeiIVQ Penr�it i�eceivec6 Avera e Lakeshore Se�ba g <br /> � Yes � t�o Q� N/A , Q::Yes' ` o <br /> � C] Yes ` No � Yes C! No /A <br /> , Permi#Number: Setback: , <br /> H�rdcover�ones Existin Pro osecf �ariance ui d Cl1P.Re i <br /> 0-75' � Yes (�o C3 Yss . No <br /> 75-250' TYPe(s): Type(S); <br /> � 250-500' <br /> 500-1000' <br /> REMARKS (in-house): <br /> Updated: 09/11/2009 <br /> z:\forms�plan review checklist.docx <br />