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�'��� �E�'EE��' ���C�{�.E�� ��E� ���,�' ���PJ�����5 � ���6�O��fS <br /> e�ddres$: _ ` �i t�S �i t�r�� �i-��?��,�=• �!Q i� Permit I�o.:-���- cs��3� <br /> Description of work: �e�C��r.f `�= t�vu;�E_ Dat� Rec'd: `�-� — ?��� <br /> Y . . . . . � . . . <br /> Septic review by: i� f✓f Date Approved: <br /> Zoning review'by; ng ,� Date A,pproved: <br /> � Builcling review by: ' _ : : Date ApProved:_�' S'�,t?1 � <br /> Grading review by: ` ��� Dete+��pprovedc <br /> ning District: Zoning Fife#: Reso#: Reso Date: <br /> � Zon �Lot Area: _ SF/AC Width: : Lot'Coverage: SF °fo <br /> Survey S: itted: � Yes q No Date of SurveY� Revised date � : <br /> � Pro os.ed Sef cks: <br /> Front(Lake) Rear(Street) ( A! S E VI� ) ( Fi S E l�V )' Other Buildi s . llfletland <br /> Side Side <br /> � �efir�ed Height: Peaic k�#ght: FI�E: FFE rninus fi et� <br /> (Lx�stin�Conto4 <br /> Perimeter(linear feet)_ �fl%_� L.�. beiow grade #of Storfes: <br /> . �OR A BUILDING.WITH A BASENi£N7 OR CRA SPACB: FOR A BUIl.DI ON A SLAB FpUNAA;ION: <br /> The distance be the lowest p►oposed The tlist8nce t�ehMeert the top of <br /> START WITH - fioqr�of the baseknefi r,crainil spac�j$nd STJIRT WIfiH slab andthe hi�hest pcihit dfihe . <br /> . the t�ighesE point of Uae' ' rCof. <br /> . if you have a... ; , If you have a:.. - . ; <br /> _ • GABLE OR HIPPED RO (no-_ • f3ABLE QR HIPREd F�OOF <br /> windows): S�uMEact half tstance (bo wi��owS): 9ubtraet-half_. <br /> t+etvreen the,h�hest�ai�t �of . !he dlstance betwean�he : <br /> ' � � to ihe Iow.PDRYk of ttie co�respo i h7ghest poirrt of the robf to <br /> SlJ¢TRACTIOM gabteori�ippQdroof the:ibyrppint•�Fthe <br /> {BAS�D ON corresPond�ng'g�bie cr <br /> ROOFTYPE • ' 'GABLE QRfiIPP�D f200F SUBTRl�CiaOT1. , hipp�[oof =. : ' <br /> . ) windows):.�u4rtract hal� i�tance (BAS�Q dN . . CAB�ORti1PPCU F�bO� <br /> bet�ree�the�p of ine��� �st ��. � ROOE,TYP�)� � � (w�tFi��ngi5da�ws�:-,`u�traot ; <br /> : - � window antl ttie high poiclf of the haH the;disiance h etweer► <br /> ' . , r°°f ' the tap. the hi 'est� ' <br /> �_ Y. .. <br /> � ' • A4L OTHER R F TYPE3(8at, . ; wihdoihc�8�d the F►igt�st <br /> ,marisard. .No subtraction., . Point of th�roof <br /> ' S .. CTIfON Subtract�e di nce be�h the •. ACj,i��`t1ER;f�OQ�TYP�S <br /> BASED ON . _ (flet r�nsar�,�eta) No� <br /> f basemenU spaCe floar and the " ' su��n . <br /> � �XiSTING` higMe�t �r�p 9�de adjacent to the �ICflD�71dN Atld�he dtstaiis:e beiween � <br /> G12ADES) - found n OR iD f@et(whichever is less). �f�' <br /> (BASEfl f3N of slab and the hi�heSt.e�sH� <br /> ��S d building heiyht EXISTING gcade adjacent to tfie foundetbt►. <br /> � : ` . '. GRAD�S , <br /> , `. : <br /> ` �14�� bei�ned building hetght <br /> Shoreiand.Dtstri MC�VD Permit �►W�ge L�akesfiore S� ck' ' <br /> • Nie#? . - ` . Biwff ",;; ' <br /> . � Yes Mo , Permit Number.' 0 �Yes 0 No CI N/A fl Yes G Mo <br /> . , . . ., . <br /> � N/A-see attached - S eck: <br /> ` Stormwa` Quaiity Exi�#ing H�rdcover p�aposed <br /> Overl Distriat (o�o and s� Hardcover Variance Required GU equired <br /> Tier,circle one %Q and <br /> G Yes O No � Yes No <br /> 1 2 3 4 5 Type(s)� Type(s}: <br /> pdated: January 2095 <br /> z:\forms�plan review checiclist 2015.docx �,� ��-�� �`��� <br />